Lifeline Care Plan AgreementLifeline Care Plan Agreement • May 16th, 2024
Please complete this Care Plan Agreement with information that you would like Lifeline Trained Care Specialists to have ready in case of an emergency. Please return this Care Plan Agreement to Lifeline using the envelope included with your equipment box.
Lifeline Care Plan Agreement Page 1 of 2Lifeline Care Plan Agreement • January 8th, 2021
This is a PARTIAL Install (Must complete all fields outlined in bold) This is a FOLLOW-UP Install; Number of pages included: 1 or 2 Program Name LIFELINE OF NEGMC Program Phone Number 770-219-8899
