Assisted Snow Removal Program Application

Please Note:

Residents already participating in Dedicated Accessible Transit Service (DATS) and Assisted Waste Collection Services can enroll in the Assisted Snow Removal program through a simplified process. Please provide your details below and our team will contact you to gather additional information to support your request.

Contact Information for the Resident Requiring Assistance

First Name

Last Name

Address

Postal Code

Note: Assisted Snow Removal Services are not intended for apartments, condos and other residences with general maintenance services, including snow removal.

Primary Phone

Alternate Phone

Translation/Interpretive Service Available

Do you require interpretation services in a language other than English?

YesNo

Please tell us which language?

How long do you need help?

All winter season (October-April): I have a mobility challenge and need ongoing help

Temporary: I have a temporary mobility challenge and will only need help for a short period

Is there a person who acts as an Appointee and provides support to the resident?

YesNo

First Name

Last Name

Primary Phone

Alternate Phone

Relation to the Resident

Translation/Interpretive Service Available

Do you require interpretation services in a language other than English?

YesNo

Please tell us which language?

Personal information and your healthcare professional’s information are collected to register you in the City of Edmonton’s Assisted Snow Removal program and will be used to administer and deliver this program. Optionally, you may receive information about other City services or programs in the future by checking the opt in box above. Collection and use is authorized under section 33(c) of the Freedom of Information and Protection of Privacy (FOIP) Act and is managed and protected in accordance with the Act. If you have any questions or concerns about the collection, use, or disclosure of this information, please contact the Complaints Investigations Section Director at Versa Commercial Centre, 201, 9304 41 Avenue, Edmonton, AB T6E 6G8, by phone at 780-496-5221 or email assistedsnowremovalprogram@edmonton.ca.