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:
WelbeHealth is a Program of All-Inclusive Care for the Elderly (PACE), full-service healthcare provider that helps you live your life healthy and happy, in your own home.
Procare First Home Health Inc. is a Medicare and MediCal-certified Home Health Agency. Procare First Home Health Inc. provides services to home-bound patients with various diagnoses. Procare First Home Health Inc. does...
Our team of dependable, compassionate and trustworthy caregivers at Caring Angels Home Care, LLC. assists clients of all ages with non-medical home care needs. We are focused on providing exceptional In-Home services with...
We specialize in providing value-based, comprehensive care and coverage for older adults with significant needs so they can thrive in the homes they love and in the communities they cherish. Our high-touch, team-based...
Aging, disability, illness or injury can make living at home a challenge. We believe that no one should have to face the long list of complex decisions and unforeseen changes alone. We are experts, providing not just...
We are committed to provide unmatched services for the elderly in the comfort of their own home! Since 2011, we have been serving the LA area with the top quality homecare you can find!
The Amada Senior Care team in San Fernando Valley is dedicated to going beyond basic home-care by gaining a deep understanding of clients and their individual needs so that they can make a truly positive impact on their...
Founded in 2020 by industry veterans. After 16 years of combined home care nursing experience across different aspects of the home care field, Prestige Home Care Angels' founders decided to start their own home care...
At Happier Home Care, we take the time to discover what makes each of our clients happy; then we incorporate those special activities into the care we provide. We are passionate about bringing happiness back into our...
At Interim HealthCare of Chatsworth, we understand how important it is to have someone you can depend on when you or someone you love wants to stay at home to maintain the highest level of health and independence. That's...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
At Senior Helpers of North Valley, we are committed to providing personalized, compassionate care that meets the needs of both seniors and their families. We believe that everyone deserves to age with dignity, purpose,...
Backed by over 25 years of industry experience, our team at VIP Home Care has delivered quality elder care, supporting thousands of clients throughout the region.
Home Care Placement is a local, privately owned in-home care, placement, and care management agency. Our mission is to provide a compassionate, world-class customer service experience to our patients and clients. Our...
BURBANK CITY HOME HEALTH, INC is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mother Theresa's Home Health Services is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Health Integrated Services Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Magnolia Home Health Care Services, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Silverado’s skilled care team excels in both helping assess clients’ needs and providing the skilled care they need to maintain a good quality of life in the familiar surroundings of home. Whether requiring short-term...
American Homecare Health Srvs is a home care provider that services in Burbank, CA. 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...
Providence Home Care is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advance Home Care, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
United Care Home Healthcare Agency, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A To Z Home Health, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Healthnet Home Care Services, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gbc Care Continuum, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caritas Home Health Providers, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Your loved one deserves the utmost quality of life, and to retain as much agency as possible. Journey Palliative and Hospice is dedicated to making sure that every patient receives empathetic care that maximizes autonomy...
Lavanda Home Health Care Agency, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heroes Healthcare Inc. is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ibolit Home Health, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
1st Choice Caregivers, provides in-home care for seniors and families to enable clients to live happy, healthy lives at home. We help seniors live happy, healthy lives in the comfort of their own homes by providing...
Ambiance Home Health is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Professional Nursing Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Golden Hills Healthcare Services, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Lady of Refuge Home Care, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It’s time to make a decision for your loved one; do you keep them at home or research other options? I have been in the home care profession for nearly 30 years and have found that most people want to stay in the...
Premier Nursing, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Burbank Home Health Care, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It is our mission to provide our clients with exceptional home care services and achieve the optimum wellness they deserve. You deserve to have the optimum level of health and comfort. Whenever life’s difficulties...
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...
Ease of Mind Hospice is a home care provider serving Tarzana, CA 91356. Our services enable seniors to stay safely in their own homes while receiving medical care or assistance with personal tasks. We offer a range of...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
With Koda Caregiver personal care services, we help your relative or loved one with intimate non-medical care needs. Our companion care services provide daily companionship and assistance with daily living activities (ADLs).
At Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations as...
WelbeHealth is a Program of All-Inclusive Care for the Elderly (PACE), full-service healthcare provider that helps you live your life healthy and happy, in your own home.
Procare First Home Health Inc. is a Medicare and MediCal-certified Home Health Agency. Procare First Home Health Inc. provides services to home-bound patients with various diagnoses. Procare First Home Health Inc. does...
Our team of dependable, compassionate and trustworthy caregivers at Caring Angels Home Care, LLC. assists clients of all ages with non-medical home care needs. We are focused on providing exceptional In-Home services with...
We specialize in providing value-based, comprehensive care and coverage for older adults with significant needs so they can thrive in the homes they love and in the communities they cherish. Our high-touch, team-based...
Aging, disability, illness or injury can make living at home a challenge. We believe that no one should have to face the long list of complex decisions and unforeseen changes alone. We are experts, providing not just...
We are committed to provide unmatched services for the elderly in the comfort of their own home! Since 2011, we have been serving the LA area with the top quality homecare you can find!
The Amada Senior Care team in San Fernando Valley is dedicated to going beyond basic home-care by gaining a deep understanding of clients and their individual needs so that they can make a truly positive impact on their...
Founded in 2020 by industry veterans. After 16 years of combined home care nursing experience across different aspects of the home care field, Prestige Home Care Angels' founders decided to start their own home care...
At Happier Home Care, we take the time to discover what makes each of our clients happy; then we incorporate those special activities into the care we provide. We are passionate about bringing happiness back into our...
At Interim HealthCare of Chatsworth, we understand how important it is to have someone you can depend on when you or someone you love wants to stay at home to maintain the highest level of health and independence. That's...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
At Senior Helpers of North Valley, we are committed to providing personalized, compassionate care that meets the needs of both seniors and their families. We believe that everyone deserves to age with dignity, purpose,...
Backed by over 25 years of industry experience, our team at VIP Home Care has delivered quality elder care, supporting thousands of clients throughout the region.
Home Care Placement is a local, privately owned in-home care, placement, and care management agency. Our mission is to provide a compassionate, world-class customer service experience to our patients and clients. Our...
BURBANK CITY HOME HEALTH, INC is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mother Theresa's Home Health Services is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Health Integrated Services Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Magnolia Home Health Care Services, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Silverado’s skilled care team excels in both helping assess clients’ needs and providing the skilled care they need to maintain a good quality of life in the familiar surroundings of home. Whether requiring short-term...
American Homecare Health Srvs is a home care provider that services in Burbank, CA. 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...
Providence Home Care is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advance Home Care, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
United Care Home Healthcare Agency, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A To Z Home Health, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Healthnet Home Care Services, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gbc Care Continuum, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caritas Home Health Providers, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Your loved one deserves the utmost quality of life, and to retain as much agency as possible. Journey Palliative and Hospice is dedicated to making sure that every patient receives empathetic care that maximizes autonomy...
Lavanda Home Health Care Agency, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heroes Healthcare Inc. is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ibolit Home Health, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
1st Choice Caregivers, provides in-home care for seniors and families to enable clients to live happy, healthy lives at home. We help seniors live happy, healthy lives in the comfort of their own homes by providing...
Ambiance Home Health is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Professional Nursing Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Golden Hills Healthcare Services, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Lady of Refuge Home Care, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It’s time to make a decision for your loved one; do you keep them at home or research other options? I have been in the home care profession for nearly 30 years and have found that most people want to stay in the...
Premier Nursing, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Burbank Home Health Care, Inc is a home care provider that services in Burbank, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It is our mission to provide our clients with exceptional home care services and achieve the optimum wellness they deserve. You deserve to have the optimum level of health and comfort. Whenever life’s difficulties...
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...
Ease of Mind Hospice is a home care provider serving Tarzana, CA 91356. Our services enable seniors to stay safely in their own homes while receiving medical care or assistance with personal tasks. We offer a range of...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
With Koda Caregiver personal care services, we help your relative or loved one with intimate non-medical care needs. Our companion care services provide daily companionship and assistance with daily living activities (ADLs).
At Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations as...
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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.