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IBM product accessibility request form

In order to provide you adequate product accessibility information, please complete the request form below. Provide as much information as you can, as well as contact information so we may easily reach you for clarification if needed.

The fields indicated with an asterisk (*) are required to complete this transaction; other fields are optional. If you do not want to provide us with the required information, please use the Back button on your browser or close the window or browser session that is displaying this page, to return to the previous page.


Request information
Required fieldWhat is this request for?

Informational only

    

Anticipated purchase — decision timeframe (mm/yyyy):

  

General information/services needed

Which of the following accessibility services are you interested in (select all that apply)?

Web accessibility

  

Software accessibility

Enterprise transformation

  

Accessible documentation

Accessibility education

  

Hardware/infrastructure
accessibility

IBM Research technologies you are interested in:

CaptionMeNow

  

ViaScribe

Easy Web Browsing

  

Webadapt2me

Contact information
Required field First name:  
Required field Last name:  
Required field Agency/company name:  
Required field Mailing address 1:  
  Mailing address 2:  
Required field City:  
Required field State:  
Required field Zip code:  
Required field E-mail address:
(e.g., johndoe@xxxx.com)		  
  Telephone:  
IBM sales representative or IBM reseller, if known:  
Customer number, if known:  
To develop appropriate product solutions, it is helpful for us to know the type(s) of disability(ies) that are appropriate to your needs: (Select all that apply):
Low vision No vision Hearing impaired
Mobility Cognitive  
Additional information
This data may be used by IBM or selected organizations to provide you with information about other offerings. To receive this via e-mail, check the first box below. Alternatively, if you would prefer not to receive such information by any means, check the second box.

Please use e-mail to send me information about other offerings.

Please do not use this data to send me information about other offerings.
 
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