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If you need to apply for Medical Assist or renew your existing Medical Assist allowance, please complete the application below.

Before starting, please make sure you have a copy of your CAPS statement of payment handy (PDF, JPEF or PNG format), as you will need to attach this before you can submit your application.

All fields are required unless marked as optional

Applicant details

Select your application type

Details of the CAPS recipient

Property details for this application

Does the applicant currently live at this property *

Applicant relation to property

What is the relation of the applicant living at this residence?

Select a status for the applicant *

Statement of payment

To qualify for the Medical Assist allowance you need to provide your CAPS statement of payment. We accept scans or photos of the original copy.

Files should be in PDF, JPEG or PNG.

Declaration

By submitting this Medical Assist application I/We declare that:

    a. I/We am the Applicant;
    b. All information provided in this application is, to the best of my knowledge, true and accurate and not misleading;
    c. I/We will immediately notify the Water Corporation of any changes to the contact details specified.
    d. I/We consent to the Water Corporation collecting, storing and using the personal information given as part of my/our contact details in accordance with the Water Corporation privacy policy for the purposes of providing a water service to me/us, and in particular for the purposes of contacting me/us by SMS/Email in the event the Water Corporation plans to complete work on assets that have an impact on my/our water supply.
    e. I/We acknowledge that Water Corporation will notify of planned interruptions to the supply via SMS/Email