Augusta, GA · Richmond County
Assisted Collection Physician Form
Augusta residents use this form to request assisted garbage and recycling cart collection, with a physician verifying their physical inability to move carts to the curb.
What this form is
Residents who cannot take their garbage and recycling carts to the curb may use this form to request assisted collection service. The resident provides contact details and signs the form, while an attending physician states whether the disability is permanent or temporary and provides contact and license information. Augusta Solid Waste reviews requests and schedules an on-site visit before making a final service determination.
Who needs it
Augusta residents seeking assisted cart collection who cannot move their carts to the curb and have no one at home able to help may need this form.
How to submit it
Mail the completed form to Augusta Solid Waste, 4330 Deans Bridge Road, Blythe, GA 30805; scan and email it to [email protected]; or fax it to 706-592-3255.
About notarization
This form does not require a notary; the resident and physician sign and date their respective sections.
How to submit this form
- 1
Download The Form
Download the Assisted Collection Physician Form.
- 2
Complete The Resident Section
Enter your contact details, verify the information requested, and sign and date the resident section.
- 3
Ask Your Physician To Complete The Statement
Have your attending physician complete the Physician’s Statement, indicate whether the disability is permanent or temporary, and sign and date it.
- 4
Submit The Completed Form
Mail, scan and email, or fax the completed form to Augusta Solid Waste using the contact details provided.
Frequently asked questions
- Who should complete the Assisted Collection Physician Form?
- The resident requesting assisted collection completes and signs the verification section. Their attending physician completes the Physician’s Statement and provides the requested license and contact information.
- How do I submit the Assisted Collection Physician Form?
- Mail it to Augusta Solid Waste at 4330 Deans Bridge Road, Blythe, GA 30805; scan and email it to [email protected]; or fax it to 706-592-3255.
- Do I need a notary for the Assisted Collection Physician Form?
- No. This form does not require notarization; the resident and physician sign and date their respective sections.
- What happens after Augusta receives the form?
- An Augusta Solid Waste representative will contact the resident to schedule an on-site visit. After the visit, the city makes a final service determination.
Need something notarized?
This Assisted Collection Physician Form doesn’t need a notary — but if you have another Augusta form that does, a commissioned online notary can help.