LifeGuardian New Account Sign-Up

Quickly & easily sign-up for your FREE LifeGuardian Medical Alarm System here. If your order is received by 1pm PST, your complete LifeGuardian System ships the same business day!

1) Order By Phone - 800-378-2957 Ext #1

Our LifeGuardian Medical Alarm staff of friendly knowledgeable representatives are standing by to assist you. We can discuss your needs and recommend monitoring plans, optional accessories and subscriber services.

2) Online Order Form

Use our LifeGuardian order form below to order your Free LifeGuardian Medical Alarm System online:

Step #1: Tell Us Who Will Be Using The LifeGuardian System
Please Note: * required field.
New Subscriber Account
  
*Subscriber (User) Name:
*Physical Address:
Apartment/Unit #:
Nearest Cross Street:
*City
*State:
*Zip Code:
*Telephone Number:
 (Include Area Code)
Email Address:
Your Long Distance Company?
How Did You Hear About Us?
Senior Super Saver Special:
 FREE Standard Shipping
 
Step #2: Choose Your LifeGuardian Monitoring Service Plan
 
Choose Your Service Plan:
 
Step #3: Tell Us Who Should Be Billed
* Bill To Subscriber                 Bill To Another (complete below)
Full Name:
Billing Address:
City:
State:
Zip Code:
Phone Number:
Email Address:
 
Step #4: Tell Us Your Preferred Payment Method
Deduct From Checking/Savings Account (ADD One Extra FREE Month Of Service!)
Bank Name:
Account Number:
Routing Number:
OR
: LifeGuardian 911 Medical Alert Alarm Systems
Select Card:
Name On Card:
Card Number:
Expiration Date:
 Month: Year:
*Card CVV Number
  (3 or 4 Digit Security Code On Card)
 
Step #5: Tell Us Where We Should Send Your LifeGuardian System
*         
Delivery Name:
Delivery Address:
City:
State:
Zip Code:
Phone Number:
Email Address:
 
Step #6: LifeGuardian Upgrades & Accessories
Key Safe Lock Box (Add $39 each) - Exterior lockable safe for quick key access.
Extra 400' Wireless Help Button (Add $4/mo) - Plus pendant, wristband & clip.
Extra 1500' Wireless Help Button (Add $4/mo) - Includes belt/clothing clip.
Wireless Wall/Hallway Help Button (Add $4/mo) - Mount anywhere in the home.
Wireless Smoke Detector (Add $8/mo) - Reports smoke/fire to center.
Wireless CO2 Detector (Add $8/mo) - Reports presence of CO2 to center.
Priority Mail Service (Add $40) - Shipped next business day by USPS Priority Mail
Expedited Service (Add $99) - Next day set-up & Next Business Day Delivery.
 
Step #7: Accept The LifeGuardian Service Agreement
*Agreement Acceptance:
*Accepted By (Type Name):
*Date Completed:
*Phone Number:
*Email Address: