Assisted Collection Form for the Refuse and Recycling Service
The Assisted Collection Service is provided to households that are unable to place their wheelie bins at
the boundary of their property on collection day, due to frailty or physical impairment.
Question 1:
Name of person/s to receive the service: ________________________________________________
Address (to which the request relates): _________________________________________________
_______________________________________________________ Post code: ________________
E-Mail: ___________________________________________Telephone: ______________________
Question 2:
If you are requesting this service on behalf of someone else please provide your details. If not please
go to Question 3.
Your name: _______________________________________________________________________
Your Address: _____________________________________________________________________
_______________________________________________________ Post code: ________________
E-Mail: ___________________________________________Telephone: ______________________
Question 3:
Please confirm that there is nobody in your household who is able to place your wheelie bins at the
boundary of your property on collection day.
I am / We are physically unable to place our bin/s out on collection day. (Please specify the reason).
________________________________________________________________________________
________________________________________________________________________________
Question 4:
Please specify the containers for which you need an Assisted Collection. (Please tick).
Refuse Bin
□
Recycling Bin
□
Recycling Box
□
Question 5:
The containers that you need assistance with must be easily accessible by our crews. Please specify
the location of your containers (e.g. next to front door).
________________________________________________________________________________
NB. It is essential to get your address number put on your particular bins so they can be returned
to where you normally store them by our collection crews.
Declaration: I declare that the contents of this document are true.
Signed: ______________________ Name: ____________________________ Date: ____________
Please note that it can take up to 10 working days to process your request.
You will be contacted by a member of the team to confirm when your assisted collections will commence.
If you have any questions please email: environment@lewisham.gov.uk
Please return this form to:
Refuse and Recycling, Wearside Service Depot, Wearside Road, Lewisham, SE13 7EZ