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.
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I acknowledge and authorize
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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:
Maxxcare Home, LLC provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, personal care, and companionship,...
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CJ Homecare LLC is a trusted provider of non-medical in-home care services, dedicated to improving the quality of life for seniors and individuals with disabilities or chronic conditions. Our compassionate caregivers...
At CareFirst Home, we believe compassionate care starts at home. Our dedicated team provides personalized, in-home support that helps seniors and individuals with special needs live safely, comfortably, and independently.
Arbor Village Services LLC is a dedicated home care agency specializing in providing high-quality, personalized care services to individuals in the comfort of their own homes.
When you have an aging family member in Greenwood, IN who may benefit from senior care, Senior Helpers Greenwood is here to help. At Senior Helpers of Greenwood, we offer comprehensive care, and can tailor a package that...
At TRS, we provide compassionate, personalized care that enhances the quality of life for our clients in the comfort of their own homes. We are committed to delivering professional, reliable, and empathetic...
Arsell Home Care LLC offers compassionate, personalized in-home care services for seniors and individuals with disabilities. Our skilled caregivers assist with daily activities, provide medical support, and offer warm...
At Vesta Structured Family Care, we extend beyond traditional care services; our foundation is built on compassion and a personalized approach to support. We are passionately focused on serving seniors, driven by a...
Attendant care provided by a personal care agency refers to non-medical, hands-on assistance with daily living activities for individuals who need help due to age, disability, or illness. This type of care is designed to...
People Helping People Quality Care is a trusted non-medical in-home care agency serving individuals and families throughout the Indianapolis area. The agency is dedicated to enhancing the quality of life for seniors,...
At Right at Home Indianapolis West, we understand that every journey is unique. Whether you’re here seeking support to live independently, or you’re looking for peace of mind knowing a loved one is in capable hands, our...
Coable Home Care Inc provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical support, and companionship,...
At Precise Home Care Agency, we believe care should be personal. Our skilled and compassionate team provides reliable in-home support—from help with daily routines to companionship and specialized care—empowering clients...
At Magic Touch Home Care LLC, we understand the challenges of caring for a loved one. Our dedicated caregivers provide a range of services, from personal care to companionship, all designed to support your loved one's...
Gentle Home Personal Care in Indianapolis offers compassionate in-home assistance, tailored to each client's unique needs, ensuring comfort and independence. Our dedicated caregivers provide a nurturing environment,...
At Humble Beautiful Care LLC, our mission is to provide compassionate, person-centered care that uplifts the spirit, honors the dignity, and enhances the quality of life for every individual we serve. We are committed to...
Unique Comfort Home Care LLC provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical support, and...
At Amada Senior Care of Greater Indianapolis, our goal is to walk with seniors and their loved ones through every step of their senior care journey. They are committed to preserving dignity and giving families the peace...
We’re intentionally different. We set the benchmark for excellent home care by balancing our friendly nature, person-centered approach, and discreet services with our love of helping you maintain your independence. It’s...
Residential Care LLC provides compassionate and personalized in-home care services. Our dedicated caregivers assist with daily tasks, promoting independence, comfort, and safety while enhancing the quality of life for...
At Brightness Home Care LLC, our mission is to illuminate the lives of our clients by providing compassionate, high-quality, and dependable in-home care services. We are committed to enhancing the quality of life for...
Center of Peace Services LLC offers compassionate and personalized in-home care for seniors and individuals with disabilities. Our skilled caregivers provide support with daily activities, medical care, and companionship,...
ABOVE AND BEYOND LLC is a home care provider that services in Camby, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homelights Care LLC provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical support, and companionship,...
Heart To Home Quality Comfort Care LLC is dedicated to providing compassionate, high-quality in-home care services that prioritize the health, safety, and well-being of every individual we serve. Our team of trained and...
Chinua C Services LLC provides compassionate and personalized in-home care for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical support, and companionship, creating...
JOURNIS PATHWAY RESIDENTIAL SERVICES LLC is a home care provider that services in Camby, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Choose Angel Home Care Services LLC for unparalleled compassion, professionalism, and dedication in caregiving. Serving the Indianapolis community, we prioritize personalized care plans, ensuring your loved ones receive...
Sent from Haven Personal Care is a full service agency with 24/7 availability. We know life doesn't happen only from 9-5 and we are here to help you no matter the time.
Annie Home Care Services LLC is a home care provider that services in Camby, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Miracle Hands Home Care LLC, we believe in delivering compassionate, high-quality, and personalized in-home care to seniors. Our mission is to enhance the well-being and quality of life for seniors by offering a range...
Heebee Homecare Agency - Camby Office is a home care provider that services in Camby, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Miracle Hands Home Care LLC is a home care provider that services in Camby, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Shirley`S Southern Love & Care LLC is a home care provider that services in Camby, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Blessing of Hearts LLC is a home care provider that services Indianapolis, IN 46203. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
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.