MLAK order form for Victorian Companion Card holders

The Victorian Office for Disability and the Victorian Companion Card are partnering with the Master Locksmiths Association of Australasia (MLAA) to provide one free Master Locksmith Access Key (MLAK) to Companion Card holders in order to increase access to Changing Places facilities.

Changing Places toilets are secure and private facilities for people with disability who have high support needs and require additional space and assistance to use a bathroom. Changing Places include an adult-size, height adjustable change table, a ceiling tracking hoist, and enough room for two people to assist either side of a central toilet. Changes Places are accessed using an MLAK key.

Each Victorian Companion Card holder is entitled to one free MLAK key. MLAA acknowledges the support of the Victorian Government in this initiative.

Your Companion Card number, for example: V032312004275/01.
Cardholder's name(Required)
Guardian/carer's name (if applicable)
Address(Required)
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Privacy statement

The information you provide in this form is personal information within the meaning of the Privacy and Data Protection Act 2014 (Vic) and health information within the meaning of the Health Records Act 2001 (Vic). 

All information collected throughout this application will be recorded and stored in a database and used solely for the purposes of administering the Master Locksmith Access Key to eligible Victorian Companion Card users. 

The information you provide in this application form will not be shared, used or disclosed to anyone who is not involved in the administration or implementation of the MLAK/Companion Card program. 

The Master Locksmiths Association of Australasia, as a body funded by the Victorian Government, authorises details collected to be shared with the Companion Card program, within the Office for Senior Victorians, Department of Families, Fairness and Housing.

By providing your information in this application form, you, or your agent/guardian on your behalf, consent to the use and disclosure of your information, as set out in this Privacy Statement.

The information collected can be accessed via a Freedom of Information request.

The information supplied will be handled in accordance with the privacy principles contained in the Privacy and Data Protection Act 2014 (Vic) and the Health Records Act 2001 (Vic).