You can use a survey to conduct your survey. One of my clients used Survey Monkey and was able to replicate the OFCCP mandated self-id of a disability form. Here are two OFCCP FAQs to answer your question. If you'd like to see the Survey Monkey form, contact me directly. 2. Some contractors may find that it is necessary to make non-substantive changes to the self-identification form to ensure that the form is accessible to employees and job applicants with print disabilities. These changes could include, for example, changes to the font, margins, and colors used on the form. Are contractors allowed to make these types of changes to the self-identification form? Yes. Contractors seeking to ensure that the form they use is accessible are allowed to alter the margins of the form, change the color of the section headings, remove or change the color of the border surrounding the text of the form, alter the appearance of the examples of disabilities (e.g., in one list instead of columns), or make other similar non-substantive changes if those changes are required to make the form accessible. Contractors may also use HTML to make the form accessible. However, contractors may NOT: Alter the content (i.e., text or wording) of the form; Alter the order of the content on the form; and Alter the form or make changes that diminish the general accessibility of the form. 5. What information must a contractor store in order to demonstrate its compliance with the requirement to invite voluntary self-identification of disability from applicants and employees? Recognizing that contractors may have different practices and information technology capabilities, OFCCP is providing a range of options for documenting compliance with the voluntary invitation to self-disclose disability requirement. Paper Invitations. A contractor that invites voluntary self-identification of disability by using paper copies of the OFCCP self-identification form must retain either the hard copies of the completed self-identification forms, or electronic copies (e.g., pdf, scanned, etc.) of the completed paper forms. The contractor must also retain any log, spreadsheet, or database that it may have developed to record the data from the self-identification forms. Electronic Invitations. A contractor that electronically invites voluntary self-identification of disability must either: Retain electronic copies (e.g., pdf, scanned, etc.) of the electronically completed self-identification forms, as well as any log, spreadsheet or database it may have developed to record the data from the self-identification forms; Retain hard copies of the electronically completed self-identification forms, as well as any log, spreadsheet or database it may have developed to record the data from the self-identification forms; or Retain a detailed log, spreadsheet or database of the data collected from each electronically completed form, without copies of each individually completed form, if the electronic system does not store completed forms. However, the contractor must also be able to demonstrate how they delivered and/or displayed the voluntary invitation to self-identify. This allows compliance officers to verify that contractors met their obligation to use the OMB-approved form.