Optional Accessibility & Medical Support Form

In Partnership with Visit Knoxville and UT Medical
Optional Accessibility & Medical Support Form
The Iris Program is an awareness initiative created in partnership with Visit Knoxville and UT Medical's Event Medicine to support individuals with hidden disabilities.

Participation is voluntary and in accordance with the Americans with Disabilities Act (ADA). Choosing not to provide information will not affect your access to services or accommodations.

Information shared will remain confidential and used only by authorized personnel if assistance is needed.

By submitting this form, you are voluntarily participating in the Iris Program.
Participant Basic Information (Required)
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Participant is 18 years of age or olderParticipant is under 18 years of age
Guardian Information
Guardian Full Name (as it appears on ID)*

First NameLast Name
Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Accessibility & Medical Information (Optional)
You are not required to disclose any medical or disability-related information. Please share only what you feel comfortable providing.
Describe your disability, condition, or accessibility needs
Are there any known triggers or situations that may affect your condition?
What is the best way for staff to assist you if needed?(e.g., treatment, communication preferences, medication, mobility assistance, sensory considerations)
Emergency Contact (Optional)
Name of Emergency Contact
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Additional Information (Optional)
Is there anything else you would like staff to know to better support you?
Consent & Acknowledgment
I understand that providing this information is voluntary.I understand that this information will be shared only with authorized event and medical staff for assistance purposes.I consent to receiving a wristband to indicate I may benefit from assistance.
Your dignity, privacy, and independence are important to us.

This form is intended only to help us respond effectively if assistance is needed. Participation is optional, and you may decline to answer any questions.

If you wish to withdraw your information, simply close the form before submitting.
Should be Empty:

Optional Accessibility & Medical Support Form

Participant Basic Information (Required)

Guardian Information

Accessibility & Medical Information (Optional)

Emergency Contact (Optional)

Additional Information (Optional)

Consent & Acknowledgment