Assisted Waste Collection Service application form (blue dot)

Have you already received a Doctors Certificate?

Applicant's Details

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)

Type of assistance

Types of bin services required
Multiple options can be selected
Timeframe required
Please ensure this requirement is detailed in your medical certificate as provided by your doctor.
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
  1. 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.
  2. The Assisted Waste Collection Service is not transferable and relate to the applicant and applicant’s property only.
  3. 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.
  4. 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.
  5. The bins must be visible from the front of the property. Council and contracted collection staff will not enter side gates, backyards etc.
  6. 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.
  7. 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.