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Parking Access/Cancellation Form

Windsor Regional Hospital does not assume responsibility for any vehicle or its contents when parked on hospital property.

The hospital does not assume responsibility for damage to vehicles that are immobilized or towed. Payment for parking does not guarantee the individual a parking spot.

By completing this form and providing your license plate, your vehicle will receive an "Electronic Parking Permit" associated with its license plate.

Payment for employee parking can only be made by payroll deduction
The cost of parking is $17.40 per pay period
Minimum cancellation period is 2 consecutive weeks

*Effective Date:

*Please choose one of the following:

Please choose one of the followingParking Access
Parking Cancellation

*Please choose the campus below for your electronic parking permit.:

Please choose the campus below for your electronic parking permit.Met (Kildare Shuttle Lot)
Ouellette (Viscount Lot or Lot “E”)
Both (Met and Ouellette)

*Name:

*Employee #:

*Department:

*Email:

*Contact # (Please provide a home, cell or ext. #):

ext.

*Please identify your status:

Please identify your statusWRH Staff Member
Schulich Student/Resident
Other Affiliate

Access Card #:

This section is to be completed by Ouellette campus staff or employees who work between the two campuses that have Ouellette Parking Access. The access card # is located on the back of your ID badge.

Access Card #:

No Access Card (Check this box if you do not yet have a access card)