UnaliWear Configuration and Monitoring Center Information

Thank you for purchasing the Kanega watch! This form will provide us with the information needed to configure and ship your watch.

An important feature of the Kanega watch is the voice-activated emergency assistance. In order to activate the emergency monitoring center, we need to provide certain important information to the monitoring centers.

In addition, we need to set up the Kanega watch with your home Wi-Fi.

We will also give you the opportunity to have up to five medication reminder times pre-loaded in your Kanega Watch.

Please answer the questions in the next few pages so that we may activate your Kanega watch. (Why this is safe...)

Missing or incomplete answers may delay shipment and activation of your Kanega watch.
Wearer Information
Wearer's Name*
First Last
Wearer Address*
Street Address Address Line 2 City State ZIP Code
Does the wearer's residence have a gate code?*
Wearer's gate code
Does the wearer's residence have a lockbox?*
Wearer's lockbox code
Is there a hidden key location? Or is the lockbox location not obvious?*
Hidden key/lockbox location
Wearer's Email
Wearer's primary phone number*
Can you receive text messages on this phone?*
Wearer's secondary phone number
Can you receive text messages on this phone?
Wearer's Date of Birth:*
Date Format: MM slash DD slash YYYY
Wearer's Gender:*
(OPTIONAL)
If you wish, you can provide information for the medical alarm operators to pass along to emergency responders if they are activated. For example: drug or other allergies; chronic diseases; or specialized instructions ("No blood pressure or needles left arm").
Where do you want to ship the Kanega watch?*
Shipping Address
Street Address Address Line 2 City State ZIP Code
Wi-Fi Configuration
Find the name and password for the Wi-Fi network in your residence. The name is also called the “SSID”. Your watch uses the 2.4 GHz Wi-Fi band.

Sometimes, this name is a sequence of random numbers and letters, but people often personalize the name of a Wi-Fi network to help users identify its owners (i.e. "The Smith Family WiFi" or "Fred's Network").

Most Wi-Fi networks are protected by a password for security. You will need to provide the password so the Kanega watch can access your Wi-Fi network.

Important: Both the SSID and password are case sensitive. It is very important that these credentials are entered accurately.
Primary 2.4 GHz Wi-Fi Network Name (SSID):*
This is the WiFi at your residence.
Primary Wi-Fi Password:*
Secondary 2.4 GHz Wi-Fi Network Name (SSID):
If you have a second WiFi (like work or another dwelling), please include.
Secondary Wi-Fi Password:
Emergency Contact Information
Please enter the contact information of the responsible parties in the order that they will be contacted in case of emergency.

You may include up to three contacts. At least one emergency contact is required.
Emergency Contact #1:
Name*
First Last
Emergency Contact #1 Email
Primary phone number*
Can you receive text messages on this phone?*
Secondary phone number
Can you receive text messages on this phone?
Relationship to wearer*
Emergency Contact #2:
Name
First Last
Emergency Contact #2 Email
Primary phone number
Can you receive text messages on this phone?
Secondary phone number
Can you receive text messages on this phone?
Relationship to wearer
Emergency Contact #3:
Name
First Last
Emergency Contact #3 Email
Primary phone number
Can you receive text messages on this phone?
Secondary phone number
Can you receive text messages on this phone?
Relationship to wearer
Onboarding
For the best wearer experience and understanding of the watch’s functionality, we recommend wearers have a brief personalized call with one of UnaliWear’s Customer Success team members, preferably when you start up the watch.*
- YES, please have one of your Customer Success team members contact me to schedule my onboarding.
- NO, thank you. I will review the How-to videos and make the test call to the monitoring center after the watch's startup tutorial. I will contact Customer Success if I have questions.
Preference for contact (select all that apply):
Medication Reminders
Never forget to take your medications and pills again! The Kanega Watch medication reminders are customizable and easy to understand.

If you'd like for us to set up your medication reminder times for you before we ship your watch, just set them up here.

You can always set up, change, or remove your medication reminders from the Kanega Wearer Portal after you've received your Kanega Watch.
Would you like for us to program your medication reminder times for you right now?*
How many medication reminder times will you need? (Up to 5 times)
First medication reminder time:
: HH
MM
Second medication reminder time:
: HH
MM
Third medication reminder time:
: HH
MM
Fourth medication reminder time:
: HH
MM
Fifth medication reminder time:
: HH
MM

UnaliWear Configuration and Monitoring Center Information

Wearer Information

Wi-Fi Configuration

Emergency Contact Information

Onboarding

Medication Reminders

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