*All Devices Must Be Activated By Home & Wellness Before They Can Be Used.
Please Fill Out and Submit the Information Below to Get Your Device Activated.
Our Friendly Staff Will Let You Know That They Are Working on the Activation and Will Let You Know When Your Device is Ready to Use.

Responder Information

Medical History & Hospital Information

Payment information

NOTE: Please check your provided email address for updates on activation status
NOTE: Activations submitted after hours will be started as soon as possible, but in some cases may not be completed until the following business day.