Participation Assistance BookingThis service is provided by trained volunteers.Please note that we prefer a minimum of 24 hours’ notice for all bookings.Learn more about our Participation Assistance Service.Step 1 of 50%Personal DetailsFor the person to be using the Companion ServiceName* Prefix Mr.Mrs.MissMs.Dr.N/A First legal name Last legal name Preferred First NameAddress* Address City Postcode Date of Birth* Day Month Year Gender Information*Please selectFemaleMaleCustomPrefer not to sayGender IdentityoptionalPhone*mobile preferred if possibleEmail Emergency Contact Name*Emergency Contact Phone*mobile preferred if possibleHave you used this service before?* Yes NoIn a few words, please describe your mobility challenge*How far are you able to walk?*This will help us with determining the best travel routeWill you be travelling with mobility equipment?*For example: wheelchair, crutches, walker. Yes NoDo you have your public transport costs covered?* Yes NoAppointment DetailsAre you travelling to an appointment/landmark/attraction? Yes NoAppointment Time* Hours : Minutes AMPM AM/PMAppointment Location NameAppointment Location Address* Street number and name Appointment Location Phone Number (if known)Arrival DetailsAre you arriving by public transport?* Yes NoI am travelling by*Please SelectV/Line TrainMetro TrainBusTaxiTramOtherWhere are you coming from?*Please enter the train line or train/bus station or town from where you are departing. eg. Lilydale Line or Seymour Station or Ballarat. Be as specific as possible.Do you want to be met by the Travellers Aid buggy service?*Please note: buggy is only available at Southern Cross and Seymour station. Yes NoArrival Time*This may be different to meeting time. Hour : Minute AMPM AM/PMMeeting Point*Where do you need to meet your volunteer companion? Platform Travellers Aid Lounge Bus Terminal Taxi rank Other (please specify)Please give your specific meeting pointFor example: Royal Melbourne Hospital reception areaWhere you would like to meet the volunteer companion?*For example: Royal Melbourne Hospital, Outpatients Clinic. Please be as specific as possible.Meeting date*Please note: Please note that we prefer a minimum of 24 hours’ notice for all bookings. Bookings made on weekends and public holidays will be processed on the next business day. DD slash MM slash YYYY Meeting Time*What time do you need to meet your volunteer companion? Please note: Operation times are between 8am and 6pm, Monday to Friday. Out-of-hours services may be arranged depending on volunteer availability. Hours : Minutes AMPM AM/PMWill you be travelling alone?* Yes NoWill you require physical assistance from the companion?*e.g. to be guided by the arm, helped onto the tram, etc Yes NoPlease be advised that the other person/s must be able to assist themselves as the companion volunteer is only assigned per one person.Will you have any luggage?* Yes NoPlease be advised that luggage must not interfere with travel requirements.Any additional arrival detailsReturn Trip DetailsDo you require a Companion for your return trip?* Yes NoApproximate appointment duration*Please selectI'm not sure30 min1 hour1.5 hours2 hours3 hours4 hours5 hours6 hoursotherWill you go straight to your destination after your appointment?* Yes NoWhere would you like to be taken?*Additional return trip detailsFurther DetailsIf at the time of your booking, you have experienced any of the following, please contact us to cancel your booking: Returned from overseas within the last two weeks,Been in contact with anyone with a confirmed case of COVID-19,Have any of the following symptoms: fever, shortness of breath, coughing, sore throat, or fatigue.I agree to contact Travellers Aid to cancel my booking if I meet any of the above conditions* I agree to contact Travellers Aid to cancel my booking if I meet any of the above conditionsPlease note that Travellers Aid Australia is not responsible for the cost of your public transport costs and it is expected that you will have sufficient funds to cover your travel.CommentsThis field is for validation purposes and should be left unchanged.
