Senior Call Check Form - Change Information

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Thank you for contacting the Senior Call Check program. You can use this form to change information about your account. We are also available by phone Monday through Friday 8 am -5 pm and Saturday 9 am -3 pm. During these hours, seniors can call toll-free 1-866-50-CHECK (1-866-502-0560). Please note, Senior Call Check phone lines and robocalls are closed New Year’s, Memorial Day, 4th of July, Labor Day, Thanksgiving and Christmas.

Form responses are monitored weekdays between the hours of 8am and 4pm.

Please note that changes can take 24-48 hours to take effect.

First Name, Last Name *

Current Phone Number used for daily call *

Please change the phone number for my daily automated call to the following number:

Please change my call time to:

8am-9am

9am-10am

11am-12pm

12pm-1pm

2pm-3pm

3pm-4pm

Clear selection

Please update my address to reflect the following changes:

Alternate Contact Information - Please change the alternate name to: (first name, last name)

Alternate Contact Information - Please change the alternate phone number to:

Please add my email:

Please provide any additional feedback and please notate if you would like someone to follow-up with you.

Submit

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