Referral Form

Refer your Client

Leverage the in care giving technology to enhance your nursing staff, improve resident communication, and reduce feelings of isolations and loneliness.

I am an:

IndividualAgency

Name of the Person To Contact * Relationship to Referral *

Email Address Phone Number

Person who needs SmartCompanion

First Name * Last Name *

Phone number *

Additional Client Info
How did you hear about us

Agency Information

Name of referring agency *
Name of Person submitting referral *
Email Address Phone Number
Address * City *
State * ZIP code *
How did you hear about us

For SmartCompanion technical support, call 833-791-9200

Using Alexa technology, SmartCompanion creates a personalized, whole-home system of smart medical alert devices to help seniors maintain an independent lifestyle and provide caregivers with peace of mind.

For Living Facilities

CONTACT INFO

855-488-1081

info@smartcompanion.care