Spring Special - Exp 4/12/2021

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Call list

Please fill out all the fields below.  The primary contact is always called before 911 in the event of an alarm.

    Call List

    List in order the people you would like to be called if the primary contact (listed above) cannot be reached.

    Name
    Phone Number
    Type
    Call Before 911?
    First Name and Last Name
    xxx-xxx-xxxx
    home, cell, work, etc.
    yes or no

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    The medical alert will reside in:
    0-1 bedroom home
    2-3 bedroom home
    4-5 bedroom home
    Inquiring For:
    myself
    spouse
    relative
    friend
    other
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    How quickly do you need the system?
    As soon as possible
    within a week
    within a month
    just researching
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    Questions? Call us: 1-888-799-6255