An accessibility survey asks the people who use your site with assistive tools what they rely on and where the site fails them. This template takes about a minute: which tools they use, such as a screen reader, keyboard only or zoom, a score for how well your site works with those tools, and an open question about where it gets in their way.
It is written for a link from your accessibility statement, the page people open when they want to report a barrier. The same survey runs inside the page at the end of that statement, as a side button that stays on the edge of every page, or as a link in your support replies.
Usertick reads each written answer as it arrives, files it under a category from your list, such as ease of use or speed and reliability, and marks it as a bug, a complaint or an idea, with an urgency. Results shows the share of each tool and the average score, and selecting a tool narrows the page to the people who use it.