Current Reemo User Info: *

Please Complete Watch Recipient / Participant

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Phone *

(###)

###

####

Please select only one from the following three "Call My" options. ---------------------------- 1. Would you like to enable the "Call My Caregiver" function?

This allows users to dial a pre-programmed dedicated number through their watch.

Yes

No

2. Would you like to enable the "Call My Healthplan"?

This allows users to dial a pre-programmed dedicated number directly to their health plan

Yes

No

3. Would you like to enable the "Call My Case Manager" function?

This allows users to dial a pre-programmed dedicated number through their watch to their case manager.

Yes

No