Order a Free Information Kit

We'd be happy to mail you and another person information about the Lifeline service. Simply complete this short form and click 'Send'.

The information you provide here is only used by Philips Lifeline. It is never sold to or shared with third parties.

* Indicates required field.

CONTACT INFORMATION

* I am interested in information about Lifeline for:
	myself for a relative or friend for a patient or client
* My First Name
* My Last Name
* Address
Address 2
* City
* State
* Zip
Telephone Number

SUBSCRIBER INFORMATION

* Zip code

(Zip code where Lifeline service will be installed, used for pricing purposes only.)

ALSO SEND TO

First Name
Last Name
Address
Address 2
City
State
Zip
Telephone

* Your email address
May we send valuable information regarding Lifeline to this address? (Your confidentiality is strictly assured)
	Yes No

You can expect to receive the information within 5-7 business days.

Philips Lifeline Calls

Planning for Independent Living. Think through the next steps

My son visited the Lifeline website looking for information and made a call to the 800 number. Soon after, we had Lifeline installed and working. A week after that I was on the porch and was too faint to even get out of the chair. I pressed the button and by the time my son was reached, I was already being taken care of by emergency people. Thank goodness for your fast and sensitive service. Roberta J.