ORDER VitalCALL ONLINE Online Order "*" indicates required fields Step 1 of 7 – Bundle Details 14% Ordering VitalCALL is easy! Need help or prefer to order over the phone? Call us 1300 848 252. Let’s start by choosing a Bundle.Bundle DetailsBundle NameDeluxe BundleDeluxe Plus BundleUltra BundleUltra Plus BundleBundle Contains 1 x VitalCALL SEVEN Base Unit 1 x VitalCALL Pearl Neck Pendant or VitalCALL Pearl Wrist Pendant 1 x VitalCALL LockboxBundle Contains 1 x VitalCALL SEVEN Base Unit 1 x VitalCALL Pearl Neck Pendant or VitalCALL Pearl Wrist Pendant 1 x VitalCALL GO Mobile Pendant 1 x VitalCALL LockboxBundle Contains 1 x VitalCALL SEVEN Base Unit 1 x VitalCALL Pearl Advanced Pendant 1 x VitalCALL LockboxBundle Contains 1 x VitalCALL SEVEN Base Unit 1 x VitalCALL Pearl Advanced Pendant 1 x VitalCALL GO Mobile Pendant 1 x VitalCALL LockboxHiddenPendant Selected Choose Pendantwith Wrist Pendantwith Neck Pendant*Note: there is a $45.00 inc GST Monthly Monitoring Fee (this will be charged on your first Invoice)Choose Pendantwith Wrist Pendantwith Neck Pendant*Note: there is a $65.00 inc GST Monthly Monitoring Fee (this will be charged on your first Invoice)Choose Pendantwith Pearl Advanced Neck Pendant*Note: there is a $45.00 inc GST Monthly Monitoring Fee (this will be charged on your first Invoice)Choose Pendantwith Pearl Advanced Neck Pendant*Note: there is a $65.00 inc GST Monthly Monitoring Fee (this will be charged on your first Invoice)Pearl Advanced User Guide* I have read and agree to the Pearl Advanced User GuideInstallation (inc GST) Price: *Note: Additional fees may apply for rural installationsTotal (inc GST) Customer DetailsName* First Last Address* Street Address City State Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Post Code Phone*MobileEmail* Date of Birth* DD slash MM slash YYYY Do You Have a Pacemaker? No Yes Terms & Conditions* I have read and agree to the Terms & ConditionsPrivacy* I have read and agree to the Privacy Terms Authorised RepresentativeAuthorised Representative I do not have an Authorised Representative Name First Last Address Street Address City State Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Post Code Relationship to CustomerSelect an optionCarerFamilyFriendOtherFunding OrganisationSonSon in LawDaughterDaughter in LawGrandsonGranddaughterBrotherSisterNeighbourWifeHusbandPhoneMobileEmail Emergency Contact 1Same As Authorised Representative? Yes Emergency Contact 1 is Same As Authorised RepresentativeName First Last Relationship to CustomerSelect an optionCarerFamilyFriendOtherFunding OrganisationSonSon in LawDaughterDaughter in LawGrandsonGranddaughterBrotherSisterNeighbourWifeHusbandPhoneMobileDoes Emergency Contact 1 Have Access to Property? No Yes Travel TimeSelect an optionLives Onsite1-5 minutes5-15 minutes15-30 minutes30+ minutesNotify Only Emergency Contact 2Emergency Contact 2 I do not have a second Emergency Contact Name First Last Relationship to CustomerSelect an optionCarerFamilyFriendOtherFunding OrganisationSonSon in LawDaughterDaughter in LawGrandsonGranddaughterBrotherSisterNeighbourWifeHusbandPhoneMobileDoes Emergency Contact 2 Have Access to Property? No Yes Travel TimeSelect an optionLives Onsite1-5 minutes5-15 minutes15-30 minutes30+ minutesNotify Only Bill PayerBill Payer is Same as Customer Yes Bill Payer is Same As CustomerPayer Name First Last Payer Address Street Address City State Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Post Code Relationship to CustomerSelect an optionCustomerFamily MemberFriendFunding OrganisationCarer/doctorPOAOtherPayer Phone NumberPayer MobilePayer Email Your OrderDeluxe Bundle Monthly Monitoring Fee: $45.00 (inc GST)Deluxe Plus Bundle Monthly Monitoring Fee: $65.00 (inc GST)Ultra Bundle Monthly Monitoring Fee: $45.00 (inc GST)Ultra Plus Bundle Monthly Monitoring Fee: $65.00 (inc GST)Total (Inc GST) Payment DetailsThere are 2 payment options available: Direct Debit or Credit Card. Please select an option below: *Please Note: We accept Visa or Mastercard only for Credit Card paymentsPayment Method*Select payment methodSavings or Cheque AccountCredit CardOption 1: Pay by saving or cheque accountVitalCALL’s commitment to the Account or Card Holder, Drawing arrangements: Where the due date falls on a non-business day, we will draw the amount on the next business day. VitalCALL will not change the amount or frequency of drawing arrangements without your prior approval or notification. VitalCALL reserves the right to cancel the Automatic Withdrawal arrangements and or VitalCALL service if three or more drawings are returned unpaid by your nominated Financial Institution and to arrange with you alternate payment methods. Where a drawing fails due to insufficient funds VitalCALL reserves the right to second attempt drawing within 30 days. VitalCALL will keep all information pertaining to your nominated account at the Financial Institution, private and confidential. Please refer to the Privacy Statement and the VitalCALL (Chubb) Privacy Policy. VitalCALL’s Privacy Policy is available on request or at www.chubbfs.com/au-en VitalCALL reserves the right to charge any related administration fees with regards to the failure of the direct debt when the circumstances are based on the non-communication of the following: drawing arrangements are cancelled either by the account holder or the nominated financial institution; insufficient funds are available in the nominated bank account to meet a drawing on the due date. Account Holders commitment to VitalCALL, Your responsibilities: It is the account holder’s responsibility to ensure that sufficient funds are available in the nominated account to meet a drawing on its due date. It is the account holder’s responsibility to ensure that authorisation given to draw on the nominated account is identical to the account signing instruction held by the financial institution where the account is based. It is your responsibility to advise us if the account nominated by you to receive the VitalCALL drawings is transferred or closed. It is the account holders responsibility to arrange with VitalCALL a suitable alternate payment method if the VitalCALL – Automatic Withdrawal arrangements are cancelled by either yourself the nominated financial institution and or VitalCALL. Customer Rights: The customer may terminate the VitalCALL drawing arrangements at any time by giving written notice to us. Such notice should be received by us at least 28 business days in advance. The customer may request changes to the drawing amount and/or frequency of VitalCALL drawings by contacting us and advising your requirements no less than 28 business days prior to the due date. Where the customer considers the drawing has been initiated incorrectly (outside the VitalCALL – Automatic Withdrawal agreement) you should take the matter up directly with VitalCALL on 1300 848 252. I acknowledge that this automatic withdrawal arrangement is governed by the terms of the client service agreement detailed aboveAccount Name* BSB Number* Account Number* Bank* Branch* Option 2: Pay by credit card *Please Note: We accept Visa or Mastercard onlyName on Card Card Number Expiry Date Format: MMYY (2 Digit year only)This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
