Are you sure you want to exit? Your progress will be lost.
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.
✔
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:
At Amada Senior Care Bellevue, we take a personalized and compassionate approach to delivering senior care services to our population of elders on the Eastside of Seattle.
Apex Care Solutions is a home care provider that services in Bellevue, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Adella Eldercare, we are dedicated to providing comprehensive in-home care services for seniors and staffing CNAs to Assisted living facilities, rehabilitation facilities and Hospitals. We understand the importance of...
Aristo Healthcare Services, LLC is a healthcare staffing services company focused on providing quality staffing services, Educational Consultation and patient care. Aristo Healthcare is an emerging name in the field of...
At Rhema Health Care, we believe in creating special moments for our clients each and every day, whether at the bedside, on the phone or in the clinic. These moments touch the lives of our clients and our employees, and...
Welcome to Benmarr, where we offer loving and skillful care, in the comfort of your home. We recognize that when your family members require assistance, it’s not just about physical aide, but also about upholding their...
Hubaal Home Care is a licensed provider of Home Care in Seattle, Washington approved by the Department of Health in March 2019. We are strategically located in Washington to serve the people with disabilities and ailments...
At Masta Logic Compassionate Care LLC, we are dedicated to enhancing the quality of life for seniors through our expert in-home care services and nursing pool.
At Golden Hour Home Care, we are committed to providing compassionate, personalized care for individuals in the comfort and familiarity of their own homes. Whether you or your loved one need assistance with daily...
Homewatch CareGivers of Mountlake, WA is a home care provider that services in Bellevue, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our business is founded on the belief that providing care is not enough. We go beyond to ensure our clients maintain their freedom and find joy in everyday living.
At HomeWell Care Services, we provide live-in and hourly at-home care for seniors and others who are struggling to manage day-to-day activities like grooming, bathing, cooking or even running errands. Our knowledgeable...
At SHINING Home HealthCare LLC, we strive to provide professional, holistic, caring, compassionate and curative services to our clients, assisting them achieve maximum rehabilitation in the comfort of their own home.
Caring for an elderly family member is a monumental task that sometimes goes unrecognized. It requires selflessness, often leaving little room for personal time. Rest assured, Home Helpers Home Care of Kirkland, WA stands...
We make home care easy.Founded by leaders with clinical and business backgrounds, we bridge the essential gap between quality care and effective management.
Senior Helpers is the premier provider of senior care, wherever your senior resides. We provide in-home care and personalized care in the comfort of your own home and at other residential locations including assisted...
GIVING ANGELS HOME CAREGIVERS, LLC is a home care provider that services in Bellevue, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sun Vista Home Care Agency is a trusted provider of personalized in-home care services, dedicated to enhancing the well-being and quality of life for seniors and individuals with disabilities.
Advent Caregivers LLC is a home care provider that services in Bellevue, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Always Best Care Senior Services combines national strength and standards with local accessibility and personal service. Always Best Care Eastside is owned and operated by Michael and Patty Davis who have been active in...
Whether you are managing an illness, injury, disability, or the effects of aging, you can trust CARE HEALTHCARE to provide you with the best care services available. Through our caregivers and home care programs, we make...
We are committed to not only maintaining but also improving the quality of life for our clients. We utilize the principles of respect for individuality, dignity, privacy and independence when caring for them. My Home...
BrightStar Care of Bellevue / Eastside, WA is a home care provider that services in Bellevue, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Andelcare is the premier non-medical home care agency in Seattle, Bellevue and surrounding areas providing companionship, homemaking and personal care services. As a locally women-owned company experienced in caring for...
Andelcare is more than just a home care agency. We are a People Care Agency. We can help your loved one remain at home, bringing you peace of mind. Our professional caregivers help your loved one live their fullest...
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...
FAOH Private Home Care LLC is a dedicated home care agency committed to providing high-quality, personalized care to individuals in the comfort of their own homes.
Providence Home Services is a home care provider that services in Bellevue, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring for Health Caring for You Experience the difference compassionate care can make in the lives of your loved ones. Contact us today to learn more about our personalized home care services and how we can support...
As a home care service provider in Washington, we keep all the care and health requirements of our clients in mind. We match you with a caregiver of your choice to help you with your everyday care needs. Each member of...
Evergreen Park AFH I provides assisted living care to seniors. We are dedicated to providing the highest level of professional care to our residents while encouraging them to live as independently as possible. We promote...
Sometimes the best move is to stay right where you are – at home. Given a choice, most of us would age in our own homes. Yet too often people go through the challenges of moving when they could get the care they need...
We help your loved ones restore independence and gain a higher quality of life Giving Back at Family Best Care At Family Best Care, we provide in-home care services for your family, but that’s not all we do. We...
At GAMERICA HEALTHCARE our mission is to provide the best home care to make a real difference in our clients. As such, we strive to build a close relationship with you through our excellent communication skills and...
OUR MISSION AND VISION STATEMENT: The Agency’s mission is to provide home service worker services to client’s in their homes assisting them to achieve the highest level of potential in their day-to-day self-care...
A COMPANY You Can Trust• Capability is locally owned and operated. We deliver exceptional private duty homecare services to senior residents throughout the greater Puget Sound area. • We understand that when you select a...
A Family-Owned and founded locally in Washington State, The Home Care Company is proud to serve the entire Puget Sound Area. Utilizing 15 years of experience, we have made it our Mission to: Help Our Clients...
At SYNERGY HomeCare, we understand that people are happiest and healthiest where they are most comfortable—in their own homes. From companionship to around-the-clock care, we offer a wide range of in-home companion care...
Careage Home Health is a home care provider that services in Bellevue, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Bellevue Healthcare - a trusted partner in compassionate and excellent caregiving. We understand that life and other responsibilities can make it difficult for you to offer the level of care you desire for your...
We are dedicated to providing excellent, extensive, humane and respectful home care services to the communities we serve, while providing comfort in their own homes or other areas of their choice. At Handy Care, clients...
Signature Home Health is a home care provider that services in Bellevue, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
B’Zoe Home Caregiving Services was founded by Prossie Lockett, who immigrated to the United States from Uganda. Although she worked in the embassy, she opted to leave her home due to many reasons, including genocide, in a...
Our Mission Our mission is to provide exceptional, high quality, and multidimensional care that is rooted in competent and effectively trained professionals who diligently address the needs of those we serve and family...
SeaCare In-Home Care Services SeaCare was born out of the need to do better for our loved ones and our community. The founder of SeaCare witnessed her grandmother receiving subpar care, and she knew the only way to make...
Griswold Home Care is a non-medical home care company. We refer Caregivers who provide in-home care services including personal care, homemaking, companionship, and other home care services. Griswold Home Care was...
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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.