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Oregon Health Authority

Document Creators

Federal accessibility laws, as well as agency policies, apply to all digital content. This includes PDFs and other digital documents. You can help improve the accessibility of OHA’s digital content by ensuring that the documents you create are accessible, and by making sure you choose the appropriate format for your content.

Your Responsibilities

  • Use Publications and Creative Services (PCS) templates whenever possible.
  • Use OHA’s Document Accessibility Toolkit for more detailed, step-by-step instructions on creating accessible source documents.
  • Remember that PDFs almost always require remediation after conversion from a source document in order to meet accessibility standards. The PDF remediation process can be time-consuming and costly. In addition, making content or layout edits to a PDF post-remediation is generally not possible. An edited PDF will almost always have to be re-remediated.
    Always ask yourself: “Does this content need to be a PDF?”



More About PDFs

​Agency policy ODHSOHA 010-029 supports an “HTML preferred” approach. This means that whenever possible and appropriate, you should create a webpage, or add content to an existing web page, rather than creating a PDF.​

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For simple content (agendas, meeting minutes, simple reports, simple forms, data spreadsheets, presentations) a Word doc, PowerPoint deck, or Excel spreadsheet may suffice​. Be sure to use agency templates and accessibility guides. There is often no need to convert these document types to PDF format. However, if you have used agency templates and guides, these documents will be easier to remediate in PDF format if they need to be converted to PDF at ​any point.


Microsoft Word can be used be used to create forms. However, only simple form elements such as text boxes and checkbox​es can be made accessible in Word documents. If your form contains more complex form elements (radio buttons, dropdown menus, Likert scales, etc.) you should probably use a different platform. Complex forms created in InDesign and published as PDFs can be made accessible; however, ensuring accessibility may require substantial effort. In many cases, the best approach is to use a dedicated form builder, like Microsoft Forms, and follow its associated access​ibility guidance.


​We do not currently recommend using the Signature field (in the Prepare Forms tool). This is because the "Configure a digital ID" dialog box is not accessible to screen readers, meaning that it fails WCAG. The image below shows the digital signature configuration box in Acrobat.
Screenshot of the Configure a Digital ID for signing dialog box



In limited cases, publishing to PDF may still be the preferred option. For example:

  • ​When the content is intended entirely (or primarily) for print, and therefore needs to have a fixed layout.
  • When the content has a complex layout that includes features like vertical columns, sidebars, or non-linear structures. These types of documents are best created in InDesign rather than Word to ensure accessibility.
  • When the content is intended for a select audience and will not need to be revised or updated after it is published.

​When converting a document to PDF, never use the “Print to PDF” option. This will typically result in an untagged PDF – that is, a blank document for assistive tech users. Always use the “Save as Adobe PDF” option instead.​

Be aware that after converting a document to PDF, the resulting PDF will need to be remediated for accessibility. This requires training, access to the proper tools, and time – an average of 6 minutes per page for an experienced remediator (per DOJ estimates) –​ although the process can take longer for more complex documents.

If you used an OHA template, followe​d our accessibility guides, and avoided the “Print to PDF” option, your PDF will most likely be partly accessible after conversion. It will probably have tags; however, some of those tags may need to be manually corrected. It may also have reading order problems which can make it confusing or incomprehensible to some readers. It will almost certainly have metadata errors that can cause problems for assistive technology users. All of these things need to be manually corrected in order for a PDF to meet accessibility standards.


​The built-in Adobe accessibility checker can give helpful advice. But it is not aligned with the WCAG standard or the parallel PDF/UA standard. Therefore, it can't be relied on to give a complete report of accessibility conformance. A more reliable tool is the free PA​C 2024 checker​, which is aligned to both WCAG and PDF/UA.​​

Also note that no automated checker can provide a complete report of PDF accessibility. For example, tag validity, tag order, and reading order must be reviewed by a human document remediator.​