Adobe Acrobat Markup Tools on the Mac

Hi everyone,
I recently received a PDF document that I'm supposed to edit using Adobe Acrobat's markup tools. I've played with both preview and Acrobat, and cannot seem to figure this out. Of course, I haven't done anything regarding PDF's in a long time, so my issues could all be just me not knowing what I'm doing.
Either way, I'm wondering if this is something doable with a screen reader.
I'd love any and all help you guys could give. Thanks. :)