Have you already received a Doctors Certificate? Yes No To be eligible for an Assisted Waste Collection Service, you must first receive a Doctor's Certificate to upload with this form. Applicant's Details First Name Last Name Home Address Contact number Medical Certificate Please upload your medical certificate as completed by your doctor.One file only.2 MB limit.Allowed types: jpg, jpeg, png, pdf, doc, docx. Next of Kin Details (Secondary Contact) First Name Last Name Contact number Email Address Relationship to applicant Type of assistance Types of bin services required Multiple options can be selected Weekly general waste (red bin) Fortnightly recycling (yellow bin) Fortnightly garden organics (green bin) Timeframe required Please ensure this requirement is detailed in your medical certificate as provided by your doctor. Ongoing Short term Please specify how long assistance is required I accept I declare I am unable to move my bins from my property to the kerbside to be emptied and there are no other people who can regularly help. I will let Council know if my circumstances change and have read the Terms and Conditions Terms & Conditions Where the property is assessed by Council as presenting an unacceptable Worth Health Safety risk to collection staff, the applicant will not be provided with the service. The Assisted Waste Collection Service is not transferable and relate to the applicant and applicant’s property only. The applicant or next of kin, neighbour or friend must advise Council if the Assisted Waste Collection Service is no longer required or if circumstances change. If the applicant moves to another property than the applicant must notify Council of the change of address to enable an assessment of the new property for the Assisted Waste Collection Service. The bins must be visible from the front of the property. Council and contracted collection staff will not enter side gates, backyards etc. If Council suspects that circumstances have changed at the Assisted Waste Collection Service property, then Council may investigate as to whether there is a genuine need for the service to continue. Approved Assisted Waste Collection Services will be reviewed annually. A further medical certificate may be requested by Council as a requirement for the service to continue. The answer you entered for the CAPTCHA was not correct. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
