Timesage is an online platform so if you know the package you require and are confident in signing up yourself, all you need is an email address to get started. You may also use the email address of a trusted friend or relative as long as they are able to notify you of any actions required on your account.

This form can be used by health professionals and support workers to refer in to the service or customers who wish to discuss the packages available and require additional support to sign up.

Personal Details (of the lifeline customer)

You will need to have or set up an email address
We will contact you discuss your options



You are eligible for VAT relief if you have a physical or mental impairment which has a long term effect upon your ability to carry out everyday activities? The VAT will be deducted at the checkout point once you input your reason for VAT relief.

YesNo

Emergency Contacts or details of support worker