You can use this form to register for the You First Telecare service. Once you have submitted your details, SARH will be in touch to discuss the next steps.

You will need to provide the details of the applicant(s), the contact details of at least two emergency contacts and some information about your telephone service.

Applicant

    Applicant details - the person who will be using the Telecare Service

  • Applicant 2 details - any additional person in the household who will use the Telecare Service

 

Emergency contacts

  • Please list at least two contacts and ensure you have their permission. You can list up to five contacts, in order of preference of who to contact in an emergency. Further contacts can be added when you receive a visit from your co-ordinator.
  • Contact 1

  • Contact 2

  • Contact 3

  • Contact 4

  • Contact 5

 

Further information

 

Data Protection and Privacy Policy

    • I wish to receive advice on having a Telecare Alarm installed in my home and understand that all personal information provided by me is for the sole use of the Telecare monitoring service and other health professionals.
    • I agree to the information being held on computer, on the understanding that in accordance with the Data Protection Act, it will be treated as confidential and not disclosed to any unauthorised person without my consent.
    • I have read and understood the Privacy Policy.
 

Verification

 

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