QR Scanner Request Form

Emergency QR Scanner Software Request Form

The Daily Companion QR Scanner System is only available to registered U.S. Fire Departments, Police, Paramedic, and certified First Responder companies. To acquire the FREE scanner software, please fill out the form below and press send. Qur staff will contact your representative to validate your organization. Once approved, you will receive an email with the QR scanner software app and instructions on how to install it onto your computer tablet.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

Paramedic / Emergency Responder Company Name *

Organization Type: (Government, Private)

Address

City

Zip / Post Code

Country

Community

Point of Contact Name / Title

Phone

Best Time to Call

Email *

Anti-Spam *

My Daily Companion Account

LIFE-SAVING TOOLS

The Paramedic’s QR System that
increases your chance of saving a life

Emergency QR Scanner Software Request Form

LIFE-SAVING TOOLS

The Paramedic’s QR System that increases your chance of saving a life

Emergency QR Scanner Software Request Form

The Paramedic’s QR System that
increases your chance of saving a life