Disability-Inclusive Clinical Research Accommodation Planning Form
A fillable form for identifying, planning, and documenting participant access needs for a research procedure without requiring unnecessary disability or diagnostic disclosure.
PDF · 2 pages · 36 KB · Fillable · Free to view, download, and adapt
About this form
The form helps research teams identify and plan access needs for a specific study activity, visit, procedure, or technology. Teams complete only the fields relevant to the study and participant, and it is designed to capture what is needed for access without collecting unnecessary personal, disability, or diagnostic information.
Before the procedure, the study team confirms how the participant can request a pause, modification, assistance, or stop. An accommodation request should not by itself be treated as a reason for exclusion; safety and scientific requirements still apply.
From accommodation to design improvement
The second page is an implementation record that follows the Barrier → Accommodation → Participant Response → Design Modification sequence. It records what happened when the accommodation was used, how the participant experienced it, and whether it affected data collection, so teams can decide whether a one-time accommodation should become a standard protocol, technology, material, or staff-training improvement.
The form is part of the Accessible Adaptive VR framework and also appears in the Accessible VR Clinical Research Toolkit. It is offered here as a standalone, fillable document for teams that need only the form.
This form is research-process guidance. Adapt it to institutional policy, approved protocols, participant populations, and applicable ethics or legal requirements. It is not medical advice and not a substitute for institutional ethics review, accessibility expertise, or participant-specific clinical judgment.
We welcome feedback on barriers, accommodations, and implementation lessons from other research teams.