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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
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I consent to the sharing of my consumer health data with qualified home care agencies.*
*If I am consenting on behalf of someone else, I have the proper authorization to do so. By clicking Get My Results, you agree to our Privacy Policy. You also consent to receive calls and texts, which may be autodialed, from us and our customer communities. Your consent is not a condition to using our service. Please visit our Terms of Use. for information about our privacy practices.
Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
Share a few details and we will match you to trusted home care in your area:
Experienced Nurses and Home Health Aides Our experienced and highly trained caregivers provide the highest quality of care to both patients and their families. Our goal is to help individuals and their loved ones live...
At S&S Constant Care Services, we believe in the power of consistent, compassionate care. Our dedicated caregivers provide dependable support with daily tasks, companionship, and specialized needs—helping each client...
At Devoted 2 You Home Care, our vision is to redefine home care by delivering compassionate, client-centered services that empower individuals to live independently with dignity and purpose. Based in Akron, Ohio, we are...
We Provide AT THE HEART OF YOUR HOME, WE OFFER LOVINGLY TAILORED CARE SERVICES, ENSURING EACH OF OUR CLIENTS FEELS COMFORTABLE AND CHERISHED IN THEIR OWN FAMILIAR SURROUNDINGS. FOR THOSE SEEKING A COMMUNITY EXPERIENCE,...
Our in-home care services brighten the lives of seniors, who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier through compassionate support,...
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead ® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance the quality...
Cornerstone Caregiving is a senior home care provider in Cleveland, Ohio that is trained and ready to help your loved one today. Our leadership team holds decades of at home senior care expertise in the home care...
Bob Mikolich, owner of Amada Senior Care Westlake, understands that to provide the best quality of senior care it is necessary to support an entire family, not just a single client. He has seen firsthand the emotional and...
We at A.L.I.C.E offer Personal Care: Assistance with activities such as bathing, dressing, grooming, and toileting. Companion Care: Providing companionship and emotional support, helping with social activities, and...
We understand that finding the proper care can be a difficult and emotional decision. Our Purpose Homecare provides highly trained and compassionate caregivers to ensure your loved ones receive the care they need with the...
Menorah Park Home Health Service is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Rent a Daughter gives you the peace of mind of having someone with you 24/7 to help you with your daily routine, provide companionship and ensure your health care needs are met. Our staff is STNA/First Aid/CPR certified,...
Diamonds & Pearls Health Services LLC is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Intrepid USA Healthcare Services is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Jewish Family Service Association is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Rhema Services, LLC is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Herrington Home Care, Inc is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Maxim Healthcare Services, Inc is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Omnicare Home Health Agency, LLC is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Health Care Bridge, Inc is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Almost Family Medlink is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Thomas and Lewis Inc is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
Porscha's Heart to Heart Home Care is dedicated to providing compassionate in-home health care services, allowing individuals to maintain a safe, healthy, and balanced lifestyle in the comfort of their own homes. Our team...
Montefiore at Home is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Brigitte At Your Service Inc. is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Care Network, Inc is a home care provider that services in Beachwood, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Homewatch CareGivers, we pride ourselves on being one of the oldest and most trusted providers of customized in-home care services. We know that inviting someone into your home is an important and complex decision,...
Right at Home exists to be your guide to successful living at home. Whether you’re looking for tips on aging in place, a guide to transitional care after a hospital stay, or information on any other aging topic, we're...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
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One of our advisors will contact you soon to connect you with trusted sources for care in your area.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.