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Refer A Friend

We provide reliable assistance when you need it most.

Life Assure Medical Alert would like to offer our service to the friends and family of our satisfied customers.
Simply fill out the form; when your friend becomes a Life Assure Medical Alert customer, you will receive a Free Month of service.

Great Reliable Assistance Worth Sharing.

Receiving a FREE Month is as easy as 1-2-3!

  1. Share Life Assure with your friends
  2. Your friend becomes a Life Assure customer*
  3. Receive your next month FREE

CALL: 1-800-354-5706

Or fill out the form to receive your FREE month of medical alert service when you refer a friend.


Your Information

Your Friend's Information

Please enter your friend's first name.
Please enter your friend's last name.
Please enter your friend's phone number as 1234567890 with no dashes
Please enter your friend's email address.

Agreement Required. By submitting this form you agree to have a customer service representative contact you. *Some conditions apply.

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