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Lifeline 7000 Series Installation/ Deactivation Form

All forms received during Normal Business Hours (Mon - Fri 8:30am to 8:00pm, Sat and Sun 10:00am to 4:00pm) will be handled within four hours of receipt. Forms received out of these hours will be actioned on the next business day.

Contact Information of the person filling out form for any follow-up questions.

Step 1: Provide Subscriber Information

Step 2: Select Reason for Submitting Request

Note: Please only select cancellation once all devices have been removed from the customer's home

Step 3: Provide Home Communicator Information

Optional: Additional Subscriber Information