Add New Monitored User

Fill out the form below to add a new Monitored User to your account

"*" indicates required fields

1User Info

2Billing Info

Monitored User Information

This is the person who will be taking the video breathalyzer tests on their phone with the BACtrack View Enterprise App. One Monitored User is allowed per paid account.

Will the monitored user need a new breathalyzer sent to them?*

Yes, please send a breathalyzer to the monitored user

No, they do not need a new breathalyzer

Organization

optional

Monitored User Name*

First Last

Monitored User Email*

Monitored User Birthday*

Monitored User Cell Phone*

Monitored User Time Zone*

Other Time Zone

Monitored User Phone Brand and Model*

ie. Samsung Galaxy S10

Shipping Information

A BREATHALYZER WILL BE SHIPPED TO THIS ADDRESS. Please enter the address where you would like the breathalyzer to be shipped and what shipping method you'd like to use.

Shipping Address*

Street Address Address Line 2 City State ZIP Code

Shipping Method*

Economy (3-7 Business Days) - FREE

Expedited (1-2 Business Days) - $40

Choose User Subscription

BACtrack View Enterprise Monitoring*

Monthly ($99.99 per month)

3 Months Pre-Paid ($249.99 every 3 months) Save $50!

6 Months Pre-Paid ($499.99 every 6 months) Save $100!

12 Months Pre-Paid ($999.99 every 12 months) Save $200!

Total

Includes one-time shipping fee

Credit Card*

Card Details

Cardholder Name

Hidden

Billing Email*

Used to manage your subscription

Billing Address*

Street Address Address Line 2 City State ZIP Code

Your details are secure