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Standard Package Terms and Conditions and Required Information

Terms and Conditions

I authorize Keeping in Touch Solutions to charge my account for the selected services I have chosen with the first two months paid in advance and to charge my account every month there after for continued service until written cancellation is delivered to the mailing address stated or delivered by email. There is a $19.00 enrollment fee. This may be waived for special promotions.

Any promotions or special rates will be deducted from the first full month of service. This fee is subject to a 2 month minimum enrollment period.

Service will commence with in 48 hours of completed enrollment forms and payment of fees.

Cancellation / Refund

A written notice is required of intent to cancel services.. Letter to cancel must be sent to the stated address or sent to the cancel email address. Unused days remaining for the monthly billing cycle will not be returned to the subscriber. Full month refunds are mailed USPO to the address given at time of enrollment.

Privacy Statement:

KeepingInTouchServices.com, Keeping in Touch Solutions. com and its parent company are keenly aware of the trust you place with us. We are here to provide you with information and education about the products and services provided by Keeping In Touch Services and parent company.

We are committed to your privacy. Patient/Client privacy polices prohibit sharing, selling and/or renting personal information and data about any member or client.

We are committed to protecting your privacy and security. We do not share, sell or rent your personal information to third party companies. If you do not wish to receive marketing communications from us or participate in our special events you may opt out and not use the site

Security:

When you enroll in KITS personal and medical confidential information is needed. This confidential information is maintained on a secure, private and separate data base for medical and private client information. We take the appropriate steps to protect against unauthorized persons to alter, access, disclose or destruction of data, storage, processing practices, or security measures.

Access to this information is limited to KITS authorized management team; officers and department supervisors who are bound by confidentiality, obligations, subjected to disciplinary actions- which may include termination and prosecution.

Disclaimer:

Every effort is made to assure the accuracy of the information on this website. We can not verify or validate the accuracy or information given by the call recipients to our care callers regarding medications. All calls are recorded for safety purposes. There is a fee for copies.

Please, confirm that you have read and agree to the above Terms and Conditions

Please fill out the Required Information below

Recipients Name (required)

Recipients Street Address, Apt #, City, State, Zip Code (required)

Recipients Date of Birth (required)

Is the recipient still driving? (required)
Yes No 

Any hearing problems/devices? (required)
Yes No 

Please describe hearing problem details

List Recipients Disabilities/Conditions (required)

Best Time of Day to Call Recipient (required)

Recipients Time Zone
 Pacific Time Mountain Time Central Time Eastern Time Alaska Time Hawaii-Aleutian Time Other

Will we need to remind recipient to take medication? (required)
 Yes No

Medication Details (name of the medication, color, and dosage) (required if applicable)

Please provide two emergency contacts for us to
have on file. These contacts will be notified if we
are unable to reach the call recipient.

Your Name (First Contact)(required)

Your Relation to Recipient (required)

Your Home Phone# (required)

Your Work Phone# (required)

Your Cell Phone# (required)

Your Email (required)

How far away do you live from recipient? (required)

Do you have house keys/access to recipients home? (required)
 Yes No

Questions? Concerns? Special Message?

Second Contact Name (required)

Second Contact Relation to Recipient (required)

Second Contact Home Phone# (required)

Second Contact Work Phone# (required)

Second Contact Cell Phone# (required)

How far away does second contact live from recipient? (required)

Does second contact have house keys/access to recipients home? (required)
 Yes No

Questions? Concerns? Special Message?

Enter the four digit code in the box below (CASE SENSITIVE). This is required for security purposes.

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Keeping In Touch Solutions
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3815 River Crossing Pkwy, Suite 100 Indianapolis, Indiana 46240
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