Click on the button below to print a copy of the application form.

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Return your completed application form to:

Gill Hague
Eldercare
847 Burnley Road
Loveclough, Rossendale
Lancashire
BB4 8QL

What Happens Next
Once we have received your completed application form and all relevant information, installation will be arranged. On receipt of your unit we will carry out a courtesy call to check that you understand how to use your alarm and ensure that you have carried out a successful test call. We recommend that you carry out at the least monthly test calls.