Accessibility audits for health-care practices
Get your practice's website ready for the HHS accessibility rule
If your practice takes Medicare, Medicaid or other HHS funding, HHS's Section 504 rule says your website has to meet WCAG 2.1 AA. We test your site against that standard and give you a plain-English list of what to fix, for $490.
- No passwords or patient information needed
- Report in 5 business days, retest after 30
- Not legal advice: coverage questions go to your attorney
- The photo has no text alternative, so a screen reader can't describe it. WCAG 1.1.1
- The text is too faint. Its contrast is 1.7 to 1, and the minimum is 4.5 to 1. WCAG 1.4.3
- The form field has gray hint text but no label. WCAG 1.3.1, 3.3.2
- The link only says "Click here." WCAG 2.4.4
- The photo has a text alternative a screen reader can read out. WCAG 1.1.1
- The text is dark enough to read: 14.5 to 1. WCAG 1.4.3
- The field has a visible label tied to it. WCAG 1.3.1, 3.3.2
- The link says where it goes: "See our insurance list." WCAG 2.4.4
- 15 or more employees May 11, 2027
- Fewer than 15 employees May 10, 2028
- The standard WCAG 2.1 AA 50 success criteria, published by the W3C
Dates from 45 CFR 84.84, as amended by HHS on May 11, 2026 (91 FR 25496 in the Federal Register).
We test this website the way we'd test yours. Latest run: no WCAG 2.1 A or AA failures found by axe-core 4.14.0 across 17 pages and page states, in light and dark mode, on November 6, 2026. How we tested it
The audit
What the $490 audit includes
We test the main pages of your website: the home page, your contact and appointment pages, and the other pages patients use most. You get a report your office can read and a fix list your web person can work from.
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Automated checks
Testing engines, including axe-core, check each page for problems software can spot, such as images without descriptions, form fields without labels and text that's too faint to read.
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Manual checks
Software can't judge everything. We also go through each page using only a keyboard, zoom it to 200%, view it at phone width, and review the headings, labels, focus order and what a screen reader is given.
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A fix for every problem
Each finding names the WCAG success criterion, shows where the problem is, says how much it affects patients, and gives the fix for your platform, such as WordPress, Squarespace or Wix.
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Your pages and your vendors' pages
Patient portals, online booking and bill-pay tools usually belong to a vendor. We list those findings on their own, with a letter you can send the vendor asking for their accessibility report.
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A draft accessibility statement
A short statement for your website that says what was tested and how patients can reach you if something doesn't work for them. You review it and publish it in your practice's name.
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A retest after 30 days
Once your fixes are in, we test the same pages again and send an updated report showing what's fixed and what's left.
Accessibility audit
yourpractice.com
23 findings
- 6 high impact
- 11 medium
- 6 low
- On your site
- 17
- In vendor tools
- 6
- From manual checks
- 9
Finding 4 of 23
The "Date of birth" field on the appointment form has no label
- WCAG 2.1
- 1.3.1 Info and Relationships; 3.3.2 Labels or Instructions; 4.1.2 Name, Role, Value
- Where
- The "Request an appointment" form on yourpractice.com/appointments, third field
- Why it matters
- A screen reader announces the field as "edit text" with no name, so a blind patient can't tell what to type. The gray hint text also disappears as soon as anyone starts typing.
- Fix
- Give the field a visible label that's tied to it in the page code:
<label for="dob">Date of birth</label>
<input id="dob" name="dob" type="text" autocomplete="bday">Price
One price for the audit, paid once
Monitoring afterward is optional. There's no widget to install, and nothing renews unless you add monitoring.
Accessibility audit
$490 one time
- Your main pages, tested against WCAG 2.1 AA
- Automated and manual checks
- A fix for every problem we find, most important first
- A letter for your vendors and a draft accessibility statement
- A retest after 30 days
- The report within 5 business days
To order, call us and you'll get a secure payment link by email.
Monthly monitoring
$49 a month
Optional, after your audit. Each month we run the automated checks again on the pages from your audit and email you a short summary of anything new, such as a problem added by a site update.
It's month to month, and you can stop whenever you like.
Ask about monitoringPrices are in US dollars.
How it works
From order to retest
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Order
Order online or call us. We only need your website address and an email address for the report.
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We test
We test the public pages of your site, the ones any visitor can see. We don't ask for passwords, we don't log in to or change your website, and we never see patient records.
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You get the report
Within 5 business days you get the report and the fix list. We'll go through it with you on a call if you'd like.
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Fix and retest
Your web person or vendor makes the changes. We retest the same pages 30 days after the report and send you an updated report.
The rule
The HHS rule, in plain words
Section 504 of the Rehabilitation Act bars disability discrimination in programs that receive federal financial assistance. In May 2024, the U.S. Department of Health and Human Services (HHS) added a website and app requirement to its Section 504 rule. In May 2026, it moved the dates back a year.
The rule says the websites and mobile apps of organizations that receive HHS federal financial assistance must meet WCAG 2.1 Level AA. That standard has 50 testable success criteria. For a typical practice website, they come down to this:
- Images that carry meaning have a text description, and decorative images are marked as decorative.
- Videos have captions. Nothing plays sound by itself for more than 3 seconds without a way to stop it.
- Everything works with a keyboard alone, including menus, forms, pop-ups and the appointment widget, and you can always see where you are on the page.
- Text stands out from its background (a contrast of 4.5 to 1, or 3 to 1 for large text), and color is never the only way information is shown.
- Pages still work when text is enlarged to 200% or viewed on a narrow phone screen.
- Every form field has a label, and errors are explained in words.
- Each page has a title, real headings in order, its language set, and links that say where they go.
- Navigation stays in the same place from page to page, and nothing flashes more than three times a second.
- Messages such as "Your request was sent" are announced to screen reader users.
- PDFs and other documents posted after the date meet the same standard.
Who it covers
The rule applies to every recipient of HHS federal financial assistance, whatever its size. Size only decides the date. In its analysis of the rule, HHS estimated that about 92% of physicians and 43% of dentists receive that assistance, and it counted 453,084 covered recipients, including 168,459 physician offices and 124,384 dental offices.
Whether the rule covers your practice is a question for your attorney. We can explain the published rule, but we can't give legal advice.
Which date applies
May 11, 2027 for practices with 15 or more employees, and May 10, 2028 for practices with fewer. The rule doesn't say how to count part-time staff, so if you're close to 15, ask your attorney which date to plan for.
Exceptions
Section 84.85 of the rule lists five narrow exceptions:
- archived pages kept in a clearly marked archive area
- documents posted before the date, unless patients use them to get care or services
- content other people post on your site
- individual documents behind a password, such as a patient's own bill
- social media posts made before the date
Honest limits
What automated tools can and can't find
Every audit uses automated scanners, and they can't do the whole job on their own. The W3C, which publishes WCAG, says evaluation tools "can not determine accessibility, they can only assist." Deque, the company that makes axe-core, studied about 300,000 issues from first-time audits and found that its automated tests caught 57% of them. The rest need judgment, which is why every audit includes manual checks.
No audit can promise that your site meets the rule or that no one will ever complain. Our report says which pages we tested, on what date, how we tested them and what we found.
57% of issues were found by automated tests in Deque's study
Questions
Questions practices ask
Does the rule apply to our practice?
It applies to organizations that receive federal financial assistance from HHS. If your practice takes Medicare, Medicaid or other HHS funding, ask your attorney to confirm. HHS estimates that about 92% of physicians and 43% of dentists receive that assistance.
Which date applies to us?
May 11, 2027 if you have 15 or more employees, and May 10, 2028 if you have fewer. The rule doesn't define how to count part-time staff, so check with your attorney if you're close to 15.
Do you need our website login or any patient information?
No. We test the pages anyone can see. We don't log in to your website, change it, or see patient records. Please don't send us patient information.
Who makes the fixes?
Whoever looks after your website: your web designer, your website platform's settings, or someone in your office. The report gives the fix for each problem. For anything a vendor controls, such as online booking or a patient portal, you get a letter to send them.
Will you confirm that our site meets the rule?
No one can honestly do that from an audit. Our report says which pages we tested, when, how and what we found. Whether your practice meets the rule is a legal question for you and your attorney. The draft accessibility statement helps you describe your site accurately.
What about accessibility widgets or overlays?
We don't sell one. In April 2025, the Federal Trade Commission finalized an order requiring one overlay company to pay $1 million over claims that its widget could make any website meet WCAG (FTC press release). The fixes in our report change your site's own code and content.
How long does it take?
The report arrives within 5 business days of your order. The retest happens 30 days after the report.
What does monitoring include?
Each month we run the automated checks on the pages from your audit and email you a short summary of anything new. It costs $49 a month, it's optional, and you can stop any time.
We got an email from you about our website. Is it real?
If it came from Northshelf LLC, yes. The numbers in it come from an automated scan of your public pages on the date in the email. Reply to it or call us at (586) 217-0032 if you'd like the full results. To stop getting our emails, use the unsubscribe link in any of them or reply "no".
Is this legal advice?
No. Northshelf LLC is not a law firm. We test websites against a technical standard and explain the published rule and its dates. Ask your attorney how the law applies to your practice.
Talk to us
Northshelf LLC is a small company in Clinton Township, Michigan. Call with questions before you order, or after your report arrives to go through it together.
To order, call us and you'll get a secure card payment link by email.
Northshelf LLC is a Michigan limited liability company, ID 900305608.
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