Thank you for choosing mCare Digital and our device as your mobile personal emergency alarm. This form will enable us to set up your device and account and ensure it is ready to use out of the box.

Please answer the following questions and click ORDER NOW when completed.

Any section with an asterisk ‘*’ is compulsory and must be completed before you submit your order.

Carer/Payer Details*


Name*:
Street Address*:
Street Address2:
Suburb*:
State*:
Postal code*:
Mobile Number*:
Email*:
Relationship to Device Wearer*:
Funding Body*:
Email address for invoice:

Choice of Devices and Plans*


MW-211 (Black)
SOLD OUT!
MW-211 (White)
SOLD OUT!
MW-241 (Black)
MW-241 (White)
mCareMate (Black)
mCareMate (White)
Choice of Devices*:
Choice of Colours*:
Choice of Service Plans*:
Plan duration*:

Wearer Details*


Name*:
Street Address*:
Street Address2:
Suburb*:
State*:
Postal code*:
Phone Number*:
Email:
Date of Birth*:
Gender*:
Medical Conditions (if any):

Key Lock Security Details for Monitoring Bureau*


Do you have a Key Lock Box/Pad?*:

Pre-Set Details (SOS)*

Following contacts are the numbers that the device will contact in case of an emergency. Please note, it's only compulsory to enter 1 SOS contact. However, you can have up to 6 SOS contact options for the wearer.
SOS Contact 1 Name*:
SOS Contact 1 Phone*:
SOS Contact 1 Relationship to Wearer*:

SOS Contact 2 Name:
SOS Contact 2 Phone:
SOS Contact 2 Relationship to Wearer:

SOS Contact 3 Name:
SOS Contact 3 Phone:
SOS Contact 3 Relationship to Wearer:

SOS Contact 4 Name:
SOS Contact 4 Phone:
SOS Contact 4 Relationship to Wearer:

SOS Contact 5 Name:
SOS Contact 5 Phone:
SOS Contact 5 Relationship to Wearer:

SOS Contact 6 Name:
SOS Contact 6 Phone:
SOS Contact 6 Relationship to Wearer:

Pre-Set Details (Device Settings)*


Use SOS Details as Speed Dials*:
If enabled, this name & number will be on the contact list for the watch wearer to call individually for non-emergencies.
Voice Recognition*:
When this function is switched on, voicemail is recognised when the SOS button is pressed and SOS contacts receiving the SOS call must dial "1" (on their handset) within seven seconds after answering or the call will be automatically transferred to the next pre-programmed number.*

Pre-Set Details (Speed Dial)

You can have up to six (6) Speed Dial contacts pre-set on the watch. If enabled, the Speed Dial name & number will be on the contact list for the watch wearer to call individually for non-emergencies. This is an optional feature.​​​​​​​
Speed Dial Contact 1 Name:
Speed Dial Contact 1 Phone:
Speed Dial Contact 1 Relationship to Wearer:

Speed Dial Contact 2 Name:
Speed Dial Contact 2 Phone:
Speed Dial Contact 2 Relationship to Wearer:

Speed Dial Contact 3 Name:
Speed Dial Contact 3 Phone:
Speed Dial Contact 3 Relationship to Wearer:

Speed Dial Contact 4 Name:
Speed Dial Contact 4 Phone:
Speed Dial Contact 4 Relationship to Wearer:

Speed Dial Contact 5 Name:
Speed Dial Contact 5 Phone:
Speed Dial Contact 5 Relationship to Wearer:

Speed Dial Contact 6 Name:
Speed Dial Contact 6 Phone:
Speed Dial Contact 6 Relationship to Wearer:

Monitoring Service Emergency Escalation Plan*


I would like the monitoring company to ONLY call 000 under this circumstance*:

Authorised Contact Details*

Contact details to be provided to 24/7 Monitoring Bureau for Emergency Response.
Contact 1 Name*:
Contact 1 Relationship to Wearer*:
Contact 1 Mobile Phone*:
Contact 1 Alternative Phone*:
Contact 1 Email*:
Street Address*:
Street Address2:
Suburb*:
State*:
Postal code*:


Contact 2 Name:
Contact 2 Relationship to Wearer:
Contact 2 Mobile Phone:
Contact 2 Alternative Phone:
Contact 2 Email:
Street Address:
Street Address2:
Suburb:
State:
Postal code:


Contact 3 Name:
Contact 3 Relationship to Wearer:
Contact 3 Mobile Phone:
Contact 3 Alternative Phone:
Contact 3 Email:
Street Address:
Street Address2:
Suburb:
State:
Postal code:

Additional Information


Additional information:

Shipping Address*


Recipient Name*:
Shipping Address*:

Street Address*:
Street Address2:
Suburb*:
State*:
Postal code*:
Acceptance*:

New Client Order Form Completed!

Thank you for new order!

We appreciate your trust in mCare Digital and the team behind the mCareWatch and mCareMate personal alarms.

If you haven't received an invoice for this new order yet, please contact our customer care team at 1300 188 557 or by email at orders@mcaredigital.com.au, and we'll make sure to send it to you as soon as possible.

Once we receive your payment, we'll set up your mCare device and deliver it via Express Post.

If you have any questions in the meantime, please reach out to us using the same contact details.

Thank you again for choosing mCare Digital.

mCare Digital Customer Care