Assisted Collection Request Form

By completing the form below you are requesting assisted collection for your household waste.  The Council will consider each application on its merits and will only provide an assisted collection service if you cannot genuinely move your refuse bin, purple refuse bags or recycling boxes and bags. 

As part of the application process a home visit will be carried out by a waste monitoring officer upon receipt of your application form.  Please include a contact number on the form so that an appointment can be booked with you.

If you qualify for assisted collections you will be notified within 10 working days.

*Please note, if you are applying for assisted collection due to medical reasons you will need to provide a letter and signature from your District Nurse, Health Visitor or Care Worker to validate your request.


By submitting the form below you are declaring that the information in the form is a true representation of your current circumstances.You must understand that the provision of an assisted collection service is periodically reviewed. You must understand that giving false information will result in the cancellation of the assistance.  If your circumstances change you must inform the Waste Management Team immediately on 01773 841326.

Assisted Collection Request Form


If the property is in the Amber Valley area please enter the postcode or the first few letters of the street. Otherwise enter the full address in the box below.



Contact Details
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Do you need further information?

If for some reason you are unable to find the information which you require on our website, you can contact us by the following methods.

address logoTown Hall, Ripley, Derbyshire, DE5 3BT
address logo01773 841326 *Calls are recorded for quality and training purposes
address logoComplete our online enquiry form
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