User guide

Alert Recipient Data
Recipient 1 - (check if same as caregiver) - If yes just fill out alert information
Name Relation
Home Phone Cell Phone Email
Next Day Alerts
Low Battery Tray Low/Empty No Call In
Immediate Alerts
Help/Refill Malfuntion Missed Dose
Alert Method (check one): Text Message (cell phone) Email Voice Message
Product Support and Programming Center - 1-800-853-1458
AMAC FORM # 1806
MedSmart Remote Programming and Monitoring Information
User Information, Device Programming and Alert Message Worksheet
Complete this worksheet prior to calling the Product Support and Programming
Center. Call 1-800-853-1458 to have your MedSmart programmed and to set up your
alert messaging requirements.
MedSmart Serial # (located on bottom of unit):
MedSmart Client Data
Name DOB Gender
Address
City State Zip
Home Phone Cell Phone Email
Device Programming Information
Time Zone: Eastern Central Mountain Pacific Alaska Hawaii
# Cells in Tray
24 29
# Alarms per Day (circle): 1 2 3 4 5 6
1 2 3 4 5 6
Time of
Alarms:
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
Primary Caregiver Data
Name Relation
Address
City State Zip
Home Phone Cell Phone Email
Alert and Message Rules
Alert/Message Number of Occurrences Prompting an Alert
1 2 3 4 5 6
Missed Dose Alert
How many doses are missed before an alert is sent?
1 2 3 4 5 6
No Device Call-In Alert
# of days in row where device does not call-in before alert is sent?
1 2 3 4 5 6
Tray Low/Empty Message
How many days of pills remain in tray before alert is sent?
Programming Change
Confirmation Message
Send Notification Yes (recommended) No
(if yes, notification will be sent to first Alert Recipient via email)
Next Day Alert Delivery Time : am / pm (delivered in user’s time zone)
Recipient 2
Name Relation
Home Phone Cell Phone Email
Next Day Alerts
Low Battery Tray Low/Empty No Call In
Immediate Alerts
Help/Refill Malfuntion Missed Dose
Alert Method (check one): Text Message (cell phone) Email Voice Message
Recipient 3
Name Relation
Home Phone Cell Phone Email
Next Day Alerts
Low Battery Tray Low/Empty No Call In
Immediate Alerts
Help/Refill Malfuntion Missed Dose
Alert Method (check one): Text Message (cell phone) Email Voice Message
Recipient 4
Name Relation
Home Phone Cell Phone Email
Next Day Alerts
Low Battery Tray Low/Empty No Call In
Immediate Alerts
Help/Refill Malfuntion Missed Dose
Alert Method (check one): Text Message (cell phone) Email Voice Message
Physician (optional)
Physician Phone (optional)
Physician E-mail (optional)
Pharmacy Store Name (optional)
Pharmacy Phone (optional)
Pharmacy E-mail (optional)