Assistive Technology Services

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Application For A FREE Medical Alert System

Please fill out the information below to apply for the Medical Alert System. All applications will be reviewed and if approved you will receive a FREE Medical Alert System when funding is available.
 
We can not guarantee that all applicants will receive the alert system. We will provide as many systems as possible.
 
Assistive Technology Services promises to use all funds made available to purchase and distribute Free Medical Alert Systems and to not keep any funds for profit.
 
Please describe your health and financial situation in the message section.
 
You Must Truthfully Pass The Eligibility Test Below In Order To Proceed.
 

TAKE OUR ELIGIBILITY TEST

To receive a FREE Medical Alert System, you must honestly attest to the statements listed below. 

 
I PROMISE
that I am not financially able to afford a Medical Alert System on my own.

I PROMISE that I am ordering this Medical Alert for myself.
I PROMISE that I have never previously applied for a Free Medical Alert in the past.
I PROMISE that I will never sell the Free Medical Alert system if I receive one.

I PROMISE that I will learn more about the word of Jesus Christ.

 

If you honestly attested to all of the statements above you may proceed with this application.


 
* First name (required):

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