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Rexall Alarm Verification Form


Rexall Store Information:

Emergency Contact Information:

Please Note: Complete contact information for at least one store contacts is required. Emergency phone numbers cannot be store numbers!

A keypad code (4-digit minimum) and password are required for every contact.

Contact #1:

Contact #3:

Contact #2:

Contact #4:

Additional Emergency Contact Information (as needed):

Please list all employees that have been issued keys for store access. Please list the Phone Numbers of these contacts ONLY if they are expected to RESPOND to store Alarms.

Contact #5:

Contact #6:

Contact #7:

Contact #8:

Contact #9:

Contact #10:

Comments / Questions:


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