Your security

MEDICAL INFORMATION FORM

Have you told us of any existing medical conditions or disabilities you have?

It helps us to help you if you declare anything which may affect your health and well-being.

For example, if you have a history of falls and we are aware on our database, our monitoring station will know that you might be vulnerable in the event of an alarm activation and ensure you get an appropriate response.

It also allows our monitoring station to inform ambulance staff should you require specific assistance.

Please download and sign the form or if you need a paper copy sent out please contact us on 0333 405 2333

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Please return form to:

Rancom Security Ltd,
Serenity House
31 Gate Lane
Boldmere
Sutton Coldfield
B73 5TR