Cancel Your Existing LifeGuardian Service

To quickly and easily cancel your LifeGuardian Medical Alarm Service, complete the online Cancel LifeGuardian Service Form below and your order will be transmitted electronically direct to the LifeGuardian Customer Service office.

If you prefer, click here to print out and FAX your Cancel LifeGuardian Service Form.

Please Note: Your LifeGuardian Service Agreement requires a minimum of 30 days advance notice before your cancellation takes effect. If you are currently renting your LifeGuardian equipment, you will need to return it to us before your account can be closed. For return instructions, see the sticker on the bottom or back of your base console.

: * Indicates required field.

1. SUBSCRIBER INFORMATION
LifeGuardian Account Number:
*Subscriber (User) Name:
*Physical Address:
Apartment/Unit #:
Nearest Cross Street:
*City
*State:
*Zip Code:
*Telephone Number: (Please Include Area Code)
2. APPROVAL AND ACCEPTANCE
Subscriber, or their legal or authorized legal representative, hereby acknowledges that they have received, read, understand and accept without limitation or exception, the Subscriber Service Agreement Terms and Conditions. I agree that ordering, receipt, activation, testing or use of my System constitutes its acceptance of this Agreement and all future updates to this Agreement, as published by LifeGuardian Technologies, LLC, and it shall be binding and effective upon either execution date below or the delivery date of my System whichever occurs first. I authorize LifeGuardian Technologies, LLC. or its assignee, Monitoring Services, to initiate and commence ongoing electronic debits from my credit card or bank account for all amounts I owe under this agreement as directed above. I understand the monthly, quarterly or annual service plan selected above will renew automatically until I cancel this authorization through written notice 30 days in advance of the next billing period. I have been given the opportunity to read and make a copy this agreement prior to activating my LifeGuardian account.
*Agreement Acceptance:
*Cancelled By (Type Name):
*Date Completed:
*Phone Number:
*Email Address: