Firstly, are you contacting us for yourself ? Or on behalf of someone else ?
If for yourself , please complete sections 2 and 3 only.
If for someone else , please complete all three sections.
Section 1: Your contact details
Your relation to the alarm user Family Friend Guardian Carer Other
Title
First Name
Surname
Telephone - the best number for us to reach you on, during the day.
Email address
If you, or someone else, is legally responsible for the alarm user’s affairs (Power of Attorney, Probate etc.) please give the address for further correspondence regarding cancellation of the alarm below.
Correspondence address
Section 2: The alarm user’s details
Title
First Name *
Surname *
Date of Birth *
House Name/Number *
County * Norfolk Suffolk Cambridgeshire Lincolnshire
Please note, if the address is not in one of these four counties the user can NOT be a customer of ours! We can only cancel alarms for customers of Careline Community Service, not for other suppliers who may have a similar name.
Postcode *
Telephone 1 - the best number for us to reach you on
Your e-mail address, if you have one
Section 3: Returning the Careline equipment.
Please let us know why the alarm is being cancelled.
Moved into care home
Moved away
Passed away
Too expensive
No longer needed
Other
If you ticked "other", please give the reason or use this box to tell us anything else we might need to know regarding the cancellation
Instructions for returning the alarm.
Rental charges apply to ALL the Careline equipment up to the end of the month in which it is returned to us. This means the alarm base unit, pendant(s) and also any leads, plugs etc. that were supplied by us.
There are two ways to return the equipment to us. You can bring it to the council office in King’s Lynn in a bag or box – if you do this, please make sure you enclose the name and address of the person who had the alarm. Or we can send you a self-addressed padded bag for you to post the equipment back to us, at no charge to you. If you do this, please make sure you ask for “proof of posting” at the Post Office when you send it.
Please let us know which method you’d like to use.
I’ll bring it to the office at Careline CS, King‘s Court, Chapel St, King’s Lynn PE30 1EX
I’d like you to send a returns bag
If you’d like us to send returns bag, please let us know WHERE to send it. To the address in Section 1 To the alarm user in Section 2 To a different address
If you’d like the return bag sent to a different address, please enter this in the box below.
If you requested a returns bag and don’t receive it within 10 days of submitting this form, please let us to know to prevent further rental charges.
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