Transforming Healthcare Advisory Board Meeting Accommodations Request Form

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We want everyone to feel supported and included during our virtual meetings. Please use this form to share any accommodations or preferences that will help you participate fully. You do not need to share any medical or diagnostic information. Please fill out and submit your request at least 3 weeks before the meeting date. If you have any questions please contact glaude@thearc.org.

What's your full name? *

What type of accommodations are you requesting? *

ASL

Audio Description

Braille

Live CART Captioning

Video Captions

Transcript of recording

Other:

What types of support help you feel included and comfortable during Zoom meetings or virtual sessions? *

Captions or live transcription

Written agenda or discussion questions before the meeting

Summary or follow-up notes after the meeting

Extra time to process or respond during discussions

Breaks during long meetings

Clear visual cues or screen sharing

Chat-based communication instead of speaking

Support using Zoom features (chat, reactions, breakout rooms, etc.)

Someone I can reach out to for help (ex. If I feel triggered or confused)

One-on-one tech check or prep before the meeting

A slower pace of conversation or extra time for questions

Other:

Required

Is there someone we should include in communications to support you with Zoom access or meeting reminders? If so, please provide the person's contact information.

Do you have any other accommodations requests not listed on this form?

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