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:*
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 5 phone numbers programmed into your alarm. Please remember that mobile phones will receive a Google Map and help text message of the wearers location. Due to policy changes by Rogers Telecommunications, LiveLife Alarms is prohibited from programming 911 as one of the 5 contacts. We do have a monitored solution for less than $1 a day if you would like emergency response services, such as 911, to be a contact called during an emergency. Please call 1-877-801-7172 to ask about this option. You will receive a discount on your device order if you choose the monitored option. We appreciate your understanding!

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Phone 5: