Service Agreement

Guardian Response Alert – Service Agreement

Device LanguageEnglishMandarinCantonese

Account Number

IMEI Number

Device Phone Number

Activation Date

Date of Birth

Device ModelCS-EV07BXCS-EV04CS-EV05CS-EV10

AccessoriesLanyardCharging BaseCharging CableBelt ClipWrist BandArm Band

HTML

User & Billing Information

User Full Name

Title

Billing Name (if different)

User Address

Billing Address (if different)

Home Phone

Cell Phone

Email Address

HTML

Emergency Contacts

Contact Name

Relation

Password

Phone Number

Alert MethodSMSCall

Service FeaturesOne-Touch Calling24-Hour MonitoringVoice PromptsFall DetectionGPS TrackingGeofence

HTML

Monitoring & Preferences

Monitoring Address

Do Not Disturb Time

Monthly Fee

Contract Term

Device Fee

Agreement Checkbox *I have read and agree to the terms and conditions of this agreement.Option 2

User Signature

Signature Date

Printed Name

Emergencies don’t always happen to the elderly or visibly vulnerable. They often happen at home, during ordinary moments, when no one else is around.

Services

Smart Lock
Home & Business Security Bundles
Lone Workers
Safety for Outdoor

Company

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Service Agreement Form

Contact Info

guardianresponsealert@gmail.com
778-838-7492
www.guardianresponsealert.com