Required fields are marked with asterisks (*)

     Region of Waterloo Waste Management Division: Application Form for a Medical Exemption

 

This form is for residents of Waterloo Region with a medical condition that generates excess medical waste related garbage. Approved applicants receive 30 garbage bag tags per year. 

Personal Information collected on this form is collected under the authority of the Municipal Act and handled in accordance with the Municipal Freedom of Information and Protection of Privacy Act. Your personal information will be used by staff of The Regional Municipality of Waterloo in the administration of the medical exemption program. 

Please remember to attach all necessary documents. The Regional Municipality of Waterloo will not be held responsible for tags delayed or lost in the mail.

 

Please indicate if you are a new applicant to the medical exemption program or if you are seeking a renewal:
 

Questions regarding the collection, use, and disclosure of your personal information or any medical exemption related inquiries can be emailed to waste@regionofwaterloo.ca.