PanicTap Device Order Form

Request PanicTap devices for your property or site by completing the order details below.

Questions? Contact us at [email protected]

Property Information

Tell us about the property or site where device(s) will be used.

Property/Site Name

Property Address

Management Company Name

 Please enter full legal name

HS Custom Price MTM

HS Custom Price 1Year

HS Custom Price 2Years

Contract & Billing

Pricing is per device per month and depends on contract length selected below.

Your organization's preferred pricing options:

Number of PanicTap Devices

Select Contract Length

Billing Frequency

Would you like your device(s) to call 911 or our professional monitoring center?

Learn more about the differences here.

Billing Email

Billing Phone

Is billing address the same as the property address?

Billing Address

If your organization requires use of a 3rd party platform for invoicing/payments, please indicate:

If the platform you use is not listed, please provide further detail in "Special billing instructions" below.

Special billing instructions (if any)

Shipping Address

Specify where device(s) should be shipped.

Is shipping address the same as the property address?

Shipping Address

Special shipping instructions (if any)

Order Contact

Order Contact First Name

Order Contact Last Name

Order Contact Email

Order Contact Phone

Dashboard Access (Optional)

Provide details for the person who will manage devices online via the Apartment Guardian Dashboard. The user may view details of the devices at the property and add/manage custom alert contacts.

Dashboard User First and Last Name

Dashboard User Email Address

Add Device Operators (Optional)

Provide details for the individual(s) who will be using the device(s) on a regular basis, so that we may send them training and support information. Device operators may be property/site manager(s), maintenance staff, security staff, or any other individuals who will use the device.

Device Operator First Name

Device Operator Last Name

Device Operator Email

Terms & Conditions

This contract incorporates by reference and is subject to Apartment Guardian’s standard Terms and Conditions located here. On behalf of Customer, I have read the Terms and Conditions, and my agreement below indicates that I fully understand and agree to all of the Terms and Conditions. If I am executing this contract on behalf of a property, I represent that I have the authority to enter into this contract on behalf of the property. I acknowledge receipt of a copy of this Agreement.