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GPS Cellular Mobile Alarm Order Form

At Distress Aid Mobile Alarms, we believe that safety is a right for every one of us. But what if you or your loved ones fall or become incapacitated and can’t reach a phone? The answer is medical alarms. We are dedicated to keeping you safe in your home, allowing you to remain independent while giving you and your family peace of mind. You can feel more secure knowing that our 24-hour monitoring service can summon emergency help with the press of a push-button.

Please fill out the form below or call us directly at 705-742-5732 or 1-866-797-7751

First Name *

Last Name *


Unit #

City / Town*


Postal Code*

Phone # *


Please Select One of the Following



1. This Agreement shall be in force and effect for an initial term of one year commencing the first day after the delivery of the GPS Mobile Alarm Device and shall continue for successive one year terms at the renewal monthly rate in effect at the commencement of the respective new terms, provided that either party may terminate this Agreement at the end of the first three months or any successive one month period by giving the other not less than 30 days prior notice in writing to that effect.

2. The Customer agrees to pay in addition to all charges listed herein, any new or increased assessments, all applicable taxes, present, retroactive and future where applicable, fees, or other charges, and penalties for false alarms, imposed in respect of the alarm system by any municipality, government, police department, fire department, ambulance service or any other agency or public service.

3. The Customer agrees to pay a service charge of $25.00 for any Customer cheque or pre-authorized payment, which is not honored by 
DISTRESS AID's bank. All late payments will be charged interest, at a rate established by DISTRESS AID from time to time.

4. DISTRESS AID shall have the right to increase any fees provided herein at any time after the expiration of one year from the commencement of the term of this agreement. If the Customer is unwilling to pay the new rate, the Customer may cancel this agreement by notifying 
DISTRESS AID (30) days in advance of such cancellation.

5. The Customer shall supply a list of persons or agencies to be notified in case the alarm is activated. The Customer will notify 
DISTRESS AID of any necessary changes to such list.

6. In the event an alarm signal is received from the Customers alarm, the alarm monitoring response centre shall make reasonable efforts to notify the stipulated party (e.g., the local police, fire department, ambulance service and/or a representative of the Customer). The alarm monitoring response centre is authorized to attempt to verify the cause of the alarm signal before dispatching the stipulated party. The purpose of the verification is to determine whether or not an emergency condition exists, so that a false alarm dispatch may be averted.

7. The Customer shall be responsible for all damages to the alarm from any cause whatsoever, or for any lost or misplaced parts, and shall pay to 
DISTRESS AID the costs of repairing, or for the cost of replacement of the alarm device or parts.

8. It is understood that no matter how good the alarm device is, or how carefully it is serviced, the possibility of failure still exists. The Customer shall be responsible for regular testing of the alarm device, and agrees to notify 
DISTRESS AID of any defects found during the course of such testing.

9. It is expressly agreed that 
DISTRESS AID is not an insurer and that the parties hereto do not contemplate that the company is assuming any risk of all or any damage, loss or injury that may result upon the failure of the alarm device to operate or from the failure of DISTRESS AID, its employees or agents to perform any of their obligations hereunder. The payments herein provided for are based solely on the probable value of the services to be provided hereunder. The failure of DISTRESS AID to perform any or all of the said services shall not give rise to any liability on the part of DISTRESS AID except to return to the Customer payment of the reasonable probable value of the said services. DISTRESS AID shall not in any event be liable for any damage, loss or injury that may result from any negligence, including gross negligence, on the part of DISTRESS AID, its employees or agents. The Customer expressly agrees that in no event shall it have any claim to more than the value specified in this paragraph and hereby surrenders, abandons and waives any and all claims to further and other damages whether sounding on contract or tort.

10. Warrantees Rental System / Lifetime Warranty: Any part of the alarm device which requires service due to normal wear and tear, or defective materials or workmanship, will be repaired and/or replaced at 
DISTRESS AID's discretion.

11. This agreement constitutes the entire contract between 
DISTRESS AID and the Customer and no agreement, understanding, representation or warranty, either express or implied, other than as contained herein, shall in any way change, vary or alter the terms hereof. This agreement shall be governed by and construed in accordance with the laws of the province in which the alarm device is located.

You will be contacted within 24 Business hours to Confirm Order and Verify all Details.

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