EARS Accessible Weather Alert Radio Request-ears

EARS Accessible Weather Alert Radio Request

Use this form to request an accessible weather radio. These radio's are limited to residents in the following counties: Cheatham, Davidson, Dickson, Houston, Humphreys, Montgomery, Robertson, Rutherford, Stewart, Sumner, Trousdale, Williamson, and Wilson counties. Limit of 1 per household. Someone associated with EARS will be in touch with you after you submit the request.

First Name

Last Name

Home Address

City/Town

County

Zip Code

Email address

Phone Number

Check all that apply for your phone number:

Voice

Videophone

Text

How many Deaf/Hard of Hearing/Deafblind people are in your household?

Please check all applicable ages of person(s) with hearing loss in the household:

Child (0-12 years of age)

Teen (13-17 years of age)

Adult (18-64 years of age)

Senior (65+ years of age)

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