Here’s how alternative format services allow providers to offer comprehensive access to healthcare.

In order to provide the most comprehensive care possible, healthcare providers and organizations must be sure that all of their communications and services — from informational pamphlets to in-person doctor’s appointments — are as accessible and easy-to-understand as possible.

Just as individuals with limited English proficiency need adequate accessibility services like interpreting and translation, so too do those with blindness, low vision, or other disabilities that affect one’s ability to read texts. Alternative format services (AFS) like large print or braille make information more accessible to individuals with blindness, low vision, or certain learning disabilities. For healthcare providers, these are a critical component of developing an accessibility plan.

    Alternative formats are ways to render written text in a more accessible fashion — think along the lines of braille, large print, and audio recordings. And implementing alternative formats in your official communications and messaging isn’t just the right thing to do — it may also be required by law for certain organizations.

    Under the Americans with Disabilities Act (ADA), state and federal government agencies — along with businesses and nonprofit organizations that serve the public — are required to offer communications in formats that are accessible to individuals with disabilities. This means healthcare providers ought to be particularly proactive about offering more accessible, alternative means of communication.

    Here, we’ll explain just what AFS is and why it’s so important for healthcare providers and organizations. Plus, we’ve got a quick primer in the “Summary” section for those of you who simply need a refresher on accessibility services for patients who have low vision or blindness.

    How Alternative Formats improve accessibility services 

    Just like efforts to improve culturally and linguistically competent outreach for individuals with limited English proficiency, alternative formats allow people who are unable to read quickly (or at all) to access and easily understand important messaging about their health plans, Medicaid eligibility, healthcare procedures, and more.

    And that’s not to mention the fact that people with these disabilities also have the legal right to access this information equally under the ADA. This means that documents and other forms of media providing critical information to prospective patients or Medicaid applicants must meet certain accessibility criteria.

    The bottom line is this: Alternative text formats like large print or audio recordings allow healthcare providers to expand outreach  and help current patients make informed decisions about their healthcare. This ultimately improves health outcomes for individuals who cannot read traditional text media.

    The basics for implementing Alternative Formats

    Healthcare providers looking to offer AFS for patients should identify a common set of documents and other media that need to be offered in accessible formats. Here are just a few examples of items that you might want to consider updating in alternative formats:

    • Flyers
    • Webpages
    • Application forms
    • Letters to patients
    • Informational texts
    • Advertising materials

    To identify these documents and make them accessible in alternative formats, we recommend seeking out the advice of an agency specializing in accessibility services. Many agencies — Avantpage included — offer specialized services to bring your organization up to ADA compliance.

    While you may choose to create in-house alternative format documents, it may be best to outsource these tasks to a third-party provider who knows the ins and outs of accessibility services.

    Types of Alternative Format services available

    There are several types of AFS that healthcare providers should consider. Here’s a breakdown of the most common alternative text formats used for individuals with low vision and blindness.

    Large Print

    As the name suggests, this format features an enlarged font to make it easier for individuals with low vision or other reading difficulties like dyslexia to access written information.

    Large print typically consists of text written with 18- to 20-point font. Other non-text assets like images or logos may be enlarged as well, to improve readability. Additionally, when producing large print formats, it’s preferable to use sans serif fonts like Helvetica or Arial — these are generally considered more readable.


    Braille is a system that allows individuals who are blind or otherwise visually impaired to read text. While traditional writing is two-dimensional, braille is a tactile writing system that consists of a series of raised dots. Each configuration of dots corresponds to an individual letter of the alphabet, enabling people to read with their fingertips.

    This format has historically been printed, but with the advent of computer technology, there are now also digital braille formats. Readers can connect braille display devices to their computer, making it much easier to access braille.

    Audio and Data CDs

    Unlike braille and large print, audio and data CDs convert the written text to audio. These CDs feature an audio recording of the original text, and can either consist of recordings made by a voice actor or text-to-speech software.

    Audio CDs allow users to pop them into a CD player just like they would with, say, an album or audiobook. On the other hand, data CDs include a digital file, acting more like a storage device such as a USB flash drive.

    Additionally, some computers and smartphones may be equipped with audio readers, which play a similar function. These employ text-to-speech software that reads a given text to a listener, without having to fuss around with an actual disk.


    Just as you might translate a flyer on Medicaid eligibility into Spanish, it’s important to make sure that information is available in alternative formats for individuals with disabilities as well. Here are some key things to keep in mind as you’re looking into alternative text formats:

    • Alternative formats allow individuals with low vision or blindness to seamlessly take in information that might otherwise be inaccessible to them.
    • When converting texts to accessible formats, consider working with a trusted agency that specializes in accessibility services.
    • Alternative formats include the following:
      • Large print: This is text that utilizes an enlarged (usually around 20-pt), easily readable font.
      • Braille: This is a tactile writing system consisting of raised dots.
      • Audio and Data CDs: These include audio recordings of written text that audiences can listen to.

    Aside from being the right thing to do, offering AFS is also required by law for many organizations and businesses. Whether you’re looking to start offering accessibility services in English or if you’d like to expand your AFS to include other languages spoken in your community, Avantpage has you covered. Our accessibility experts know the ADA inside and out, so don’t hesitate to contact us at [email protected] or (530) 750-2040