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 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. 

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