Equity & Access Intake Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name & RoleOrganization TypeTransportation ProviderNonprofit / Community OrganizationEducational Institution / PartnerGovernment Agency / MunicipalitySmall Business / OtherWhat’s your current challenge?E.g., MTM onboarding, WCAG/captions, focus groups, SOPs, reporting, etc.Email * Interested In… Email Phone NumberInterested In…Transportation Broker / Medicaid Readiness (credentialing, insurance, compliance)Workflow & Training (intake→authorization→booking; staff/driver or learner training)Accessibility QA (WCAG audits, captions, transcripts)Media QA & Content Validation (video/AI content review)Learner Outreach & Toolkit Validation (focus groups, surveys)Data & Reporting (KPIs, dashboards, audit prep / validation reports)Program Design (nonprofits & education partners)General Info / Not sure yetTimeline/UrgencyASAP (0–2 weeks)2–4 weeks1–3 monthsPlanning / ExploringConsentI agree to the privacy policy and understand ALT Legacy will contact me regarding this inquiry.Submit
