QEIIMC Staff Parking Permit
Application Form

Welcome to the Queen Elizabeth II Medical Centre (QEIIMC) staff parking permit application form. The purpose of this form is to gather information to establish your need for a parking permit at QEIIMC.

QEIIMC staff who wish to park their car at the QEIIMC must have a parking permit. Your application will be reviewed by your Head of Department / Parking Approver and the Parking Department.
Application Process
  1. Agree to terms and conditions and proceed to the application.
  2. You will need to complete the questions across the following pages and submit your application.
  3. Your application will then be sent to your Head of Department / Parking Approver who will review and confirm key details and their confirmation will be sent to the Parking Department.
  4. Your application will then be evaluated by the Parking Department.
  5. The Parking Department will inform you via email of the outcome of your application.
What You Need to Complete Your Application
  1. Vehicle details such as licence plate number, manufacturer, model and colour.
  2. The organisation and department that you work for and your job title.
  3. Email address (personal).
  4. If you are a permit holder, your current permit (E-Tag) number
  5. Scanned supporting documents (if applicable) such as:
  • ACROD permit (back and front of permit)
  • Statutory Declaration (for primary carers)
  • Medical Declaration Form (if you have a medical condition that affects your mobility)
  • Your work roster (if you regularly undertake on-call duties for which you are paid an on-call allowance for)
Frequently Asked Questions
For further information, please visit the QEIIMC Parking Webpage for a list of Frequently Asked Questions
www.qeiimc.health.wa.gov.au/getting-here/parking-upgrades-at-qeiimc
If You Are a Student
If you are a student, please do not proceed any further. Please contact the Parking Department regarding parking.
If You Are a Contractor
If you are a contractor working on a construction site, please do not proceed any further. Please ask your site manager about parking.
If You Have a Motorcycle
If you use a motorcycle or scooter, you do not require a permit for it. Contact the parking department for more information. Motorcycle/scooter bays are located in car park 7 and on the ground floor of the multideck car park. Click here to download the QEIIMC Parking Map. Motorcycles/scooters that park in car bays may be subject to infringement.
Terms and Conditions
  1. I acknowledge that this application is for a parking permit for the Queen Elizabeth II Medical Centre (QEIIMC) Campus.
  2. I agree to comply with
  3. the QEIIMC (Delegated Site) By-laws 1986 as amended from time to time which can be found at https://qeiimc.health.wa.gov.au/about/acts-bylaws/
  4. the QEIIMC Trust Priority Parking Policy which can be found here at https://www.qeiimc.health.wa.gov.au/staff-parking/staff-parking-priority-groups-and-eligibility; and
  5. any term or condition on a QEIIMC parking permit; or upon entry to a QEIIMC staff or visitor car park, in connection with use of a QEIIMC parking permit.
  6. any directive given from an Authorised Person under the QEIIMC (Delegated Site) By-laws 1986
  7. any directive given by Wilson Parking Attendants
  8. I understand that it is my responsibility as the applicant to follow up on the progression of my parking application form with the QEIIMC Parking Department.
  9. I understand that until my parking application has been approved by my relevant Head of Department/Authorised Manager; processed by the QEIIMC Parking Department in accordance with the Priority Parking Policy; and, is activated online with a positive balance or a valid method of payment, I will not be entitled to staff parking on the QEIIMC Campus.
  10. I understand that having a permit does not guarantee parking on the QEIIMC Campus and that parking may not be available from time to time.
  11. I understand that the QEIIMC Trust reserves the right to withdraw my permit or change my allocated parking area under the circumstances specified in the By-laws and the Priority Parking Policy.
  12. The QEIIMC Trust, Wilson Parking and the International Parking Group (IPG) exclude all liability for any loss of, or damage to, vehicles parked in, or accessories, contents or articles left in any car park operated and managed on the QEIIMC Campus.
  13. I understand and agree that I am fully responsible for any loss or damage that I incur from parking on the QEIIMC Campus.
  14. I agree to pay the appropriate fee, according to the QEIIMC (Delegated Site) By-laws 1986, via credit card, EFTPOS or cash payments.
  15. I hereby undertake to keep my vehicle licence plate number in a presentable condition.
  16. I acknowledge that if I do not have credit (positive balance) in my parking account I will be refused access to park on the QEIIMC Campus.
  17. I understand that the permit issued to me remains the property of the Delegate of the QEII Medical Centre Trust (NMHS). It is non-transferable and will be surrendered on leaving or on demand by an Authorised Person.
  18. I agree that IPG and its subcontractors, such as Wilson Parking and Spotless, may contact me in relation to any Campus car park related incidents that I may have been involved in.
  19. I understand that, should I be found to have parked outside a marked bay or in a manner that causes safety concerns, I may be issued with an infringement notice, disqualified from parking on the QEIIMC Campus for up to 12 months (at the discretion of the QEIIMC Parking Department) or have my vehicle towed at my own expense.
  20. I understand and agree that I must provide complete, accurate and current information on this form. I understand that if this form has not been completed fully, it will not be considered for the application process.
  21. I understand that the information provided on this form will be subject to verification by my Head of Department/Authorised Manager. I understand that, should I be found to have made a materially false or misleading statement, I may be disqualified from parking on the QEIIMC Campus for up to 12 months (at the discretion of the QEIIMC Parking Department).
  22. I understand that, should I be found to have displayed behaviour contrary to the NMHS Code of Conduct in the car park or to a member of the QEIIMC Parking Department or Wilson Parking, I may be disqualified from parking on the QEIIMC Campus for up to 12 months (at the discretion of the QEIIMC Parking Department).
  23. I understand that, should I be found to have been smoking or vaping in a QEIIMC car park, I may be disqualified from parking on the QEIIMC Campus for up to 12 months (at the discretion of the QEIIMC Parking Department).
  24. I agree to inform the QEIIMC Parking Department of any changes to the information provided on this form. I understand that failure to inform the QEIIMC Parking Department may result in the revocation of my permit.