Mobile Alarm setup form

By filling out this form we’ll be able to more quickly setup your mobile alarm. You’re welcome though to call us on 1 877 801 7172 and we can gather this information over the phone.

Personal information

Order number:*
Name on order:*
E-mail:
Name of person wearing pendant:
Location address where the alarm will be worn :

Emergency contacts

Please include area codes. You can have as many as 6 phone numbers programmed into your alarm. Please remember that mobile phones will receive a Google Map and help text message of the wearers location. 

Contact 1 Name:
Contact 1 Phone:
Contact 2 Name:
Contact 2 Phone:
Contact 3 Name:
Contact 3 Phone:
Contact 4 Name:
Contact 4 Phone:
Contact 5 Name:
Contact 5 Phone:
Contact 6 Name
Contact 6 Phone: