= Required Fields

Online Form - Transport Assistance Application

Introduction

Navigate through the different form sections using the navigation on the left, or use the next/previous buttons located at the bottom of each step.

Save Your Progress

You have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address.

Clicking the next/previous button will automatically save your form.

Note: Incomplete forms are kept for a period of 7 day(s) hour(s), after this time the system will automatically delete your response.

Do you hold a valid Health Care Card or Pension Concession Card? *

Please complete card details below.

Are you applying for one individual person or as a couple? *

If so, please complete the partner related questions on the next page or skip to the next set of questions by clicking on next.


Do you hold a valid Health Care Card or Pension Concession Card?

Please complete card details below.

Is your partner receiving transport assistance via a state or federal government aged care package?
Is your partner receiving assistance from TUSS (Taxi Users Subsidy Scheme)?
Does your partner have a Department of Veteran Affairs (DVA) Health Card?
Is your partner eligible for CHSP (Commonwealth Home Support or HACC (Home and Community Care)?
Is your partner currently on the waitlist for any of these services?

Your application must be received before your medical appointment takes place, as the City is not able to provide Transport Assistance for past appointments.

Are you receiving transport assistance via a state or federal government aged care package? *
Are you receiving assistance from TUSS (Taxi Users Subsidy Scheme)? *
Do you have a Department of Veteran Affairs (DVA) Health Card? *
Are you eligible for CHSP (Commonwealth Home Support or HACC (Home and Community Care)? *
Are you currently on the waitlist for any of these services? *
Have you received funding for Transport Assistance from the City before? *
By submitting this application, I confirm that the information contained herein is to the best of my knowledge, true and correct.

Validate and Submit Form

 
Get Audio Code