Listed in *AARP® The Magazine Online Caregivers Resource Guide in 2003 as a resource for Personal Alarms

Listed in *AARP®'s "My Generation" Magazine in 2002 as a resource for Personal Alarms

Rated A+ by the Better Business Bureau with no complaints

 

Choosing a good Medical Alarm company can be difficult.
Take the time to read everyone's brochure and make an intelligent decision.
Order Online
This is the person who will be signing the paperwork, and who will be contacted about any issues with the medical alarm service.

You can select a different person for billing below if necessary. If you don't want to be responsible, the User of the system's name should be entered here. They then will be the Client/User.

Who is filling this form.

 

 

For any additional User fill out "First Name 2" and "Last Name 2". There will be a one time charge of $35.00 for the extra button for the second User of the system.

 

 

Second phone number must ring the same User residence or User address as the first phone number.

 

 

 

This is a very important section We must know if your phone line is a Cable Phone (VOIP), DSL Phone or if its a TV Cable Bundled Internet Package. NOTE Land line phones are more consistent than internet VOIP phones.

Same as AboveWho will be the User of the medical alarm?

Please tell us about your phone system and
Internet Information
-What type of phone system does the Client have?
-Do you have any special number required to reach dial tone?
-What type of Internet service does the Client have?
-What is the name of your phone company?

Response Information

How will the paramedics get into the home?

  • Location(be sure to tell us your combination)

  •    

    Location

*During an emergency if we receive no response we notify 911 first.

*YOUR PERMISSION IS ALWAYS GIVEN TO EMERGENCY PERSONNEL TO FORCE ENTRY INTO THE HOME IF NO KEY IS AVAILABLE AT THE TIME OF THE EMERGENCY.

We will call from the list in the order they are received. We will go down the list until one person is reached.

Responder 1


Responder 2


Responder 3


Responder 4


Responder 5


Responder 6


Responder 7


Responder 8


Choose Your Price Plan

$24.95 Per Month
Paid Monthly, First three months paid in advance $74.85
Then billed monthly at $24.95

$24.95 Per Month
Paid Quarterly, Cancel at anytime
Billed at $74.85 per quarter

$24.95 Per Month
Paid Semi-Annually,
Cancel at anytime
Billed at $149.70 every 6 months

$23.95 Per Month
Paid Yearly, Cancel at anytime
Billed at $287.40 per year

Help Button Selection

Necklace Button - Hangs on a 32" adjustable necklace. Wristband Button - Comes on a plastic watchband.

You can have an extra Help Button as your one Free Gift.
$35.00 Necklace Button     My One Free Gift $35.00 Wristband Button    My One Free Gift

Shipping Information

 To the address of the person ordering the system.  To the address of the person using the system.  Neither of the above, Ship to the address entered below.

Shipping Method

Free Priority Shipping $45.00 Overnight
We will ship the system out once we receive payment

 

 

 

 

 

 

 

 

 

 

 

 


Paying for the Service Now

 To the address of the person ordering the system.  To the address of the person using the system.  Neither of the above, Send to the address entered below.

Pay with Credit Card

Credit Card Information

You will see a charge from Seniorsafety.com on your statement

Pay with Electronic Check

Electronic Check Information

Send Paper Check

Mail or Fax the Check 1-888-748-7004  

SeniorSafety
2 Catamaran Street Suite #2
Marina del Rey, CA 90292
Who are we going to bill in the future

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Send Future Bills To

 To the address of the person ordering the system.  To the address of the person using the system.  Neither of the above, Send to the address entered below.

Pay Future Bills

Send Invoices to the Address Above. Send Invoices to this Email.

Pay with Credit Card

Credit Card Information - Same as Above

You will see a charge from Seniorsafety.com on your statement

Pay with Electronic Check

Electronic Check Information - Same as Above

For office use only

Privacy Policy