Assistance Now Beta Testing

Assistance Now Beta Testing Submission Form

*All fields are required.
I would like to be considered as a beta tester for the Assistance Now Smartwatch and mobile application.

Your Information
Name*
First Last
Address*
Street Address City State ZIP Code
Email*
Phone*
Your Need
The smartwatch is for (pick one)*
- Me
- Family Member
- Friend
What type of mobile phone operating system does the user have? (pick one)*
- iOS
- Android
- Windows
The Assistance Now smartwatch is needed as a safety measure due to:*
- Elderly
- Chronic Illness
- Cognitive Impairment
- Other
Administrative
Please provide basic details about the user’s health condition*
** By submitting the form, you have agreed to receive email communications from Assistance Now

About Us

Assistance Now is a technology company that specializes in Fall Detection. We offer several solutions for the home as well as while traveling. Our goal is to provide the best senior monitoring at an affordable cost.

Contact Us

Local: (949) 298-3200
Toll Free: (877) 572-3762

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Assistance Now Beta Testing

Assistance Now Beta Testing Submission Form

Your Information

Your Need

Administrative