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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:
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
There’s a reason why Unity Home Care LLC, is a leading provider of homecare in Farmington, Connecticut, and that’s simply because we truly care for you! Elderly, injured, ill, and the disabled—we make every high-quality...
At Acorn Home Care, it is our goal to provide family members and friends with peace of mind in the knowledge that when you choose us, we take very seriously our duty to guard your loved ones’ safety and keep them secure...
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...
The mission of CareCo Shoreline is to provide comprehensive, compassionate, and customized in-home services designed to help individuals remain in their homes, safe and strong.
Our Manchester, CT home health care provides safe and joy-filled homes for seniors! Seniors enjoy memorable days full of fun activities with our happy caregivers We believe joy accelerates healing. So, whether we’re...
Our family owned company was established in 1989 in New Britain, CT as Bright Cleaning Services with the intentions of providing housecleaning services in central Connecticut – Newington, Middletown, Avon, Glastonbury and...
A & B Homecare Solutions - New Haven is a home care provider that services in Bloomfield, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homewatch CareGivers of Windsor was founded on the idea that your loved one deserves to be treated with kind, compassionate care that is tailored to their unique needs, and in their preferred surroundings. That’s why we...
Our experienced and compassionate caregivers at BrightStar® Home Care Hartford provide everything from companionship and help with errands and light housekeeping to personal care services like assistance with bathing,...
Mercy Home Health Inc. is a home care provider that services in Bloomfield, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Pronatural Home Care is a home care provider that services in Bloomfield, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Oxford Home Care was founded upon the goal to provide an exceptional brand of care that helps the elderly, the sick, and the disabled members of our communities remain and stay healthy in their own homes. We recognize how...
HomeWell is committed to helping people live life more fully. With a highly personalized care management approach, our agencies strive to provide exceptional care in the place where clients feel most comfortable.
At H0PE ALIVE HOME CARE AND COMPANION, we’re dedicated to providing the support needed to ensure your loved ones receive the quality care and quality of life they deserve.
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Welcome to Love and Caring Home Care Agency LLC. We're a team of dedicated home care professionals who go above and beyond to ensure that you or your loved ones receive personalized care and timely assistance.
Seabury Home Care is a home care provider that services in Bloomfield, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heavenly Care LLC is a home care provider that services in Bloomfield, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
As a potential client, you will be assigned your own case manager who will work jointly with you to assess, plan and facilitate care coordination. He or she will evaluate clients condition, recommend options and assign...
TenderKare Home Care Agency is a private home care agency specializing in comprehensive services that are customized to meet the varied individual needs of our clients. We are dedicated to providing safe, caring, and...
Care For You, LLC is a home care provider that services in Bloomfield, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Secure Hands Solutions, we understand aging is a natural process. We can help alleviate the stress and potential risk of running errands and maintaining your home. We offer cost-effective care and flexible schedules.
Hands For Care Senior Care is a home care provider that services in Bloomfield, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Nurse Next Door we believe it’s about caring, not just health care so our priority is focusing on the needs of seniors while getting them back to being healthy and doing the things they used to love. We currently...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Bloomfield, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At OPAAT, we pride ourselves in providing exceptional care to seniors in the comfort of their home or their place of residence (i.e. assisted/independent living, long-term care, and short-term rehab facilities). We do...
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...
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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.