Order Personal Assist Unit


To order your Personal Assist GPS Tracker unit:

download-button

 

 

 

CLICK HERE TO DOWNLOAD our Application form, fill in, and send back to us, OR:

download this form in a Word format

After filling in the form, please pay via:

PAYMENT OPTIONS

  • Pay by credit card – use our By Now Paypal button
  • Post a cheque made out to Healthwatch Co Ltd – *The cheque needs to be cleared before unit can be dispatched.
  • Direct Credit or Internet Banking pay to: Healthwatch Co. Ltd,
    WestPac Bank,
    Account number: 030239 – 0114421-00


Click Pay Pal Button to purchase
Personal Assist GPS unit




INSTRUCTIONS FOR FILLING IN THE APPLICATION FORM:

  1. Fill in the user of the units full contact details.
  2. If you are the Admin person, or carer, then fill your contact details where it says administrative contact, in case we need further information.
  3. Please provide main S O S person contact details; they will be the first person that will receive the ALERT
  4. Optional: a second person contact details as a back up ALERT if the first person does not respond.
  5. There is option for one more person to be a 2nd back up contact to receive an ALERT
  6. Sign application, then enter referral agent name, (if you were referred by an agent).

POST US THE FILLED IN FORM

  1. PRINT out the PDF Application Form,
  2. Fill it in and post, (just the first page)
  3. Attach your cheque with the application (if applicable) to:

Pat Young,
HealthWatch-Medical,
PO Box 316086
Wairau Valley
Auckland 0760

EMAIL OPTION

If you download this form in a Word format and click ENABLE EDITING, and save it to your computer, you can fill it in electronically then attach it re-saved to an email to:

All Forms to go to: Pat Young (pat@healthwatch-medical.co.nz)

Customer Enquiries: 09 479-1069