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.*
✔
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:
One You Love Homecare - Huntingdon Valley/Mainline, PA is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
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...
HomeWell Care Services of Norristown, PA is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Provisions Home Healthcare Services LLC is a dedicated provider of comprehensive and compassionate healthcare services tailored to meet the needs of individuals in the comfort of their own homes. The company specializes...
We provide non-medical, aide services and companion care to seniors, elderly, and physically challenged adults. Through coordinated care and support for clients and their families, we enable our clients to live at home...
As we strive to offer companionship and holistic support for our clients, Jovial Care Givers works to enhance the quality of life for your loved ones while providing reliable in-home non-medical care in Pennsylvania.
Our Services. At 5karats of love we provide... In home care Personal care Non skilled care Monitor vital signs accompany doctor appointments Warm companionship Meal preparation Light...
At Grace Community Services, we are dedicated to delivering premium home healthcare services with transparency, security, and genuine compassion. Our innovative approach combines cutting-edge technology and a commitment...
Receptive Home Care is a leading provider of compassionate and professional in-home care services, dedicated to enhancing the quality of life for individuals who require assistance with daily activities.
YourVision Home Care is more than an agency; it's a promise of compassionate support, fostering a sense of belonging, and enriching the lives of those we serve. With open hearts and skilled hands, we embark on this...
Fidelity Home Care is a trusted provider of compassionate, high-quality in-home care services for individuals in need of assistance with daily living activities. With a strong commitment to personalized care, Fidelity...
At FirstLight Home Care of BuxMont, we provide exceptional care so that your loved one has the support they need to enjoy the quality of life they deserve in the place they call home. We exist to help people have their...
Here at Caring Hands of Humanity LLC, we aim to improve the quality of care in our community. We provide a individualized approach, and lead with compassion. It is our doctrine to ensure that all core values are met, such...
UNIQUELY PREPARED TO DELIVER excellent home care Affinity HealthCare Solutions stands apart as a home care agency that is uniquely prepared to provide trustworthy personal assistance to individuals and families with a...
Allegiant Home Healthcare is a family owned and operated non-medical home care company. We have a combined 35 years of experience in the home and health care industry. Our experience, expertise and loyalty to the...
Home Matters of Philadelphia-- Montgomery County is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
At Amada Chester County, we strive to provide the highest quality of care with a sense of warmth, kindness and compassion. Each member of our team is committed to your loved one because to us, they are family. We take...
At Healthspan Partners we specialize in delivering personalized home care services to individuals and families in Philadelphia and Delaware counties. We understand the importance of independence and dignity for our...
Reliance Home Health Care is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Mission To encourage hope and support, to maintain health and well being. Through medical practices, knowledge of new technologies, training and thorough research, we provide quality service. In Wendell’s Room...
Our One You Love Home Care location in Ambler, Pennsylvania delivers private senior in-home care to your mom, dad or other loved one so they can remain in their own home living comfortably and independently. One You Love...
AXION WORLDWIDE LLC is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
R.I.G.H.T.S! was founded on the principle that health care gets better when consumers have a team at home—the place they most want to be. From the Licensed Clinical Social Worker, Speech-Language Pathologist, Registered...
Kali Kare Homecare, LLC is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We at Griswold Home Care Referral Service realize that every home-care situation is unique and that having the correct type and amount of care for your loved one is what provides our clients with peace of mind. Whether it...
We understand that not one care plan fits all. Daily services can include anything from meal preparation, hygiene, cleaning, and supervision. We will take the time to get to know you and develop an individualized care...
Our home care agency provides essential in-home support services to seniors and individuals with disabilities, helping them maintain independence and quality of life. We offer assistance with daily activities such as...
Homewatch CareGivers of Central Bucks County, PA is a home care provider that services Warminster and the surrounding areas in PA. Home care services allow seniors to remain safely in their home, senior community or...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
One You Love Homecare - Huntingdon Valley/Mainline, PA is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
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...
HomeWell Care Services of Norristown, PA is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Provisions Home Healthcare Services LLC is a dedicated provider of comprehensive and compassionate healthcare services tailored to meet the needs of individuals in the comfort of their own homes. The company specializes...
We provide non-medical, aide services and companion care to seniors, elderly, and physically challenged adults. Through coordinated care and support for clients and their families, we enable our clients to live at home...
As we strive to offer companionship and holistic support for our clients, Jovial Care Givers works to enhance the quality of life for your loved ones while providing reliable in-home non-medical care in Pennsylvania.
Our Services. At 5karats of love we provide... In home care Personal care Non skilled care Monitor vital signs accompany doctor appointments Warm companionship Meal preparation Light...
At Grace Community Services, we are dedicated to delivering premium home healthcare services with transparency, security, and genuine compassion. Our innovative approach combines cutting-edge technology and a commitment...
Receptive Home Care is a leading provider of compassionate and professional in-home care services, dedicated to enhancing the quality of life for individuals who require assistance with daily activities.
YourVision Home Care is more than an agency; it's a promise of compassionate support, fostering a sense of belonging, and enriching the lives of those we serve. With open hearts and skilled hands, we embark on this...
Fidelity Home Care is a trusted provider of compassionate, high-quality in-home care services for individuals in need of assistance with daily living activities. With a strong commitment to personalized care, Fidelity...
At FirstLight Home Care of BuxMont, we provide exceptional care so that your loved one has the support they need to enjoy the quality of life they deserve in the place they call home. We exist to help people have their...
Here at Caring Hands of Humanity LLC, we aim to improve the quality of care in our community. We provide a individualized approach, and lead with compassion. It is our doctrine to ensure that all core values are met, such...
UNIQUELY PREPARED TO DELIVER excellent home care Affinity HealthCare Solutions stands apart as a home care agency that is uniquely prepared to provide trustworthy personal assistance to individuals and families with a...
Allegiant Home Healthcare is a family owned and operated non-medical home care company. We have a combined 35 years of experience in the home and health care industry. Our experience, expertise and loyalty to the...
Home Matters of Philadelphia-- Montgomery County is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
At Amada Chester County, we strive to provide the highest quality of care with a sense of warmth, kindness and compassion. Each member of our team is committed to your loved one because to us, they are family. We take...
At Healthspan Partners we specialize in delivering personalized home care services to individuals and families in Philadelphia and Delaware counties. We understand the importance of independence and dignity for our...
Reliance Home Health Care is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Mission To encourage hope and support, to maintain health and well being. Through medical practices, knowledge of new technologies, training and thorough research, we provide quality service. In Wendell’s Room...
Our One You Love Home Care location in Ambler, Pennsylvania delivers private senior in-home care to your mom, dad or other loved one so they can remain in their own home living comfortably and independently. One You Love...
AXION WORLDWIDE LLC is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
R.I.G.H.T.S! was founded on the principle that health care gets better when consumers have a team at home—the place they most want to be. From the Licensed Clinical Social Worker, Speech-Language Pathologist, Registered...
Kali Kare Homecare, LLC is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We at Griswold Home Care Referral Service realize that every home-care situation is unique and that having the correct type and amount of care for your loved one is what provides our clients with peace of mind. Whether it...
We understand that not one care plan fits all. Daily services can include anything from meal preparation, hygiene, cleaning, and supervision. We will take the time to get to know you and develop an individualized care...
Our home care agency provides essential in-home support services to seniors and individuals with disabilities, helping them maintain independence and quality of life. We offer assistance with daily activities such as...
Homewatch CareGivers of Central Bucks County, PA is a home care provider that services Warminster and the surrounding areas in PA. Home care services allow seniors to remain safely in their home, senior community or...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
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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.