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Get 911 Cell Phones For Seniors - The Ability Center Of Greater Toledo - Abilitycenter

Inc. 2155 Arlington Avenue Toledo, Ohio 43609 (419) 382-7060 Name: Address: Zip Code: City: State: Phone: Date of Birth: Do you have a home phone? Yes No Do you live alone? Yes No Are you taking prescription medication for a medical condition? Yes No Are you currently using a pacemaker? Yes No How did you hear about this program? Senior Center located nearest to you. Signature Office Use Only: Application Received: Disclaimer & Instruction Sheet: Serial # of Cell Phone Given.

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