CareBell Subscription Form
CareBell is a 24 x 7 remote emergency response service for your loved ones
INSTRUCTIONS:
If you are subscribing for yourself, please choose the "Myself" option.
If you are a caregiver subscribing on behalf of your care recipient (as the service user), please select the "For Care Recipient" option.
It is advisable for the caregiver to be in good health and contactable in Singapore.
If you are an Android user, search for "Carebell" in Google Play Store. Download and install the CareBell application on your mobile phone. After your subscription is activated (via an email confirmation), you can click on CareBell app to connect to CareBell SOS emergency response service.
Please be aware that the CareBell SOS mobile application currently supports
non-Huawei Android phones
only.
If you are an iOS user, please refer to the CareBell iOS setup guide in the confirmation email.
Organization ID
Purchase Date
/
Day
/
Month
Year
Date
I am subscribing
For myself
On behalf of someone (e.g care recipient)
For Self
Full Name (As in NRIC)
*
Required for the Terms of Service Agreement
Phone Number
*
Please enter a valid phone number.
Email
*
Please enter valid email address
NRIC Number
*
Required for terms of service agreement
Address
*
Street name, block and unit number
Postal code
*
Please input your postal code
Medical conditions (Recommended for faster assistance in emergency)
This is optional. However providing information regarding your medical conditions will be helpful to our care agent in the event of emergency
Subscribing on behalf Care Recipient
Care Recipient Details
Care Recipient Full Name (As in NRIC)
*
Required for Terms of Service Agreement
Is Care Recipient email same as Caregiver?
Yes
No
Care Recipient Email
Please enter valid email address.
Care Recipient Phone Number
*
Please enter a valid phone number.
Care Recipient NRIC Number
*
Required for terms of service agreement
Is Care Recipient Address same as Caregiver?
Yes
No
Care Recipient Address
*
Street name, block and unit number
Care Recipient Postal code
*
Care Recipient Medical conditions (Recommended for faster assistance in emergency)
This is optional. However providing information regarding your care recipient medical conditions will be helpful to our care agent in the event of emergency
Terms and conditions
Plan duration
Care Recipient Organization
Plan Activation Date
Plan End Date
Plan ID
Plan Description
Activation Status
Submit
Should be Empty: