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 Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
There comes a time in each of our lives when we or our loved ones need medical assistance. If you or your loved ones are facing health problems, be they temporary or chronic, it may be time to reach out for help. Hattie...
Heart 2 Heart Home Care Agency 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 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...
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.
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...
Home Instead - West Chester, PA is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Exact Home Care provides reliable and compassionate in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical support, and companionship, ensuring...
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...
At BrightStar Care Greater Chester County, we believe that caring is more than just a job– it’s a way of life. That’s why our caregivers mean so much more to the people, families, and organizations they serve. BrightStar...
KeyState Home Health is guided by integrity, empathy, and excellence in all aspects of care. We are passionate about making a positive impact on the lives we touch, offering peace of mind to families, and supporting our...
Our partnership approach to home care ensures your loved one’s needs are always a priority and always greeted with a smile. You can trust in your loved one’s health, happiness, and care thanks to our talented and...
At Newtown Caregiving Services, our mission is to provide compassionate and reliable home health care services to our clients. We strive to improve their quality of life and help them maintain independence in the comfort...
Providing Quality Care in Philadelphia Peaceful Hands Home Care is a locally owned and operated home care agency that provides quality care to seniors and adults with disabilities in the Philadelphia area. We offer a...
Our in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing compassionate care in the...
Geras Home Care Services LLC is a dedicated provider of home care services, focused on delivering high-quality, personalized care to individuals in the comfort of their own homes.
Eastern Heals Home Care services LLC is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
Criticare Home Care is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DYNAMIC HOME CARE INC is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We Provide: Bathing and dressing assistance Preparing meals Grocery shopping Light housekeeping Scheduling appointments Organizing transportation Our companionship services include, but are not limited...
CARPEVITA HOME CARE - DE/PA is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The goal of Marzar Staffing Solutions, LLC is to deliver services that are client-sensitive, and culturally diverse, while preserving dignity and integrity of our clients. Our philosophy is at the heart of everything we...
We invite you to experience the Essential Companions difference and discover how we can make a meaningful impact in your life or the life of a loved one. Contact us today to learn more about our services and how we can...
Care in the Comfort of Your Own Home North Star Home Care is committed to assisting our clients to live their best lives possible! Together, with our professionally trained caregivers and Electronic Caregiver’s...
CHN Homecare, LLC is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
As a trusted non-medical home care provider, HomeCare Instead is committed to providing exceptional personal care assistance. We encourage rehabilitation and independence of our clients, helping them achieve the highest...
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...
One You Love Homecare - Huntingdon Valley/Mainline, PA is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
There comes a time in each of our lives when we or our loved ones need medical assistance. If you or your loved ones are facing health problems, be they temporary or chronic, it may be time to reach out for help. Hattie...
Heart 2 Heart Home Care Agency 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 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...
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.
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...
Home Instead - West Chester, PA is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Exact Home Care provides reliable and compassionate in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical support, and companionship, ensuring...
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...
At BrightStar Care Greater Chester County, we believe that caring is more than just a job– it’s a way of life. That’s why our caregivers mean so much more to the people, families, and organizations they serve. BrightStar...
KeyState Home Health is guided by integrity, empathy, and excellence in all aspects of care. We are passionate about making a positive impact on the lives we touch, offering peace of mind to families, and supporting our...
Our partnership approach to home care ensures your loved one’s needs are always a priority and always greeted with a smile. You can trust in your loved one’s health, happiness, and care thanks to our talented and...
At Newtown Caregiving Services, our mission is to provide compassionate and reliable home health care services to our clients. We strive to improve their quality of life and help them maintain independence in the comfort...
Providing Quality Care in Philadelphia Peaceful Hands Home Care is a locally owned and operated home care agency that provides quality care to seniors and adults with disabilities in the Philadelphia area. We offer a...
Our in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing compassionate care in the...
Geras Home Care Services LLC is a dedicated provider of home care services, focused on delivering high-quality, personalized care to individuals in the comfort of their own homes.
Eastern Heals Home Care services LLC is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
Criticare Home Care is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DYNAMIC HOME CARE INC is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We Provide: Bathing and dressing assistance Preparing meals Grocery shopping Light housekeeping Scheduling appointments Organizing transportation Our companionship services include, but are not limited...
CARPEVITA HOME CARE - DE/PA is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The goal of Marzar Staffing Solutions, LLC is to deliver services that are client-sensitive, and culturally diverse, while preserving dignity and integrity of our clients. Our philosophy is at the heart of everything we...
We invite you to experience the Essential Companions difference and discover how we can make a meaningful impact in your life or the life of a loved one. Contact us today to learn more about our services and how we can...
Care in the Comfort of Your Own Home North Star Home Care is committed to assisting our clients to live their best lives possible! Together, with our professionally trained caregivers and Electronic Caregiver’s...
CHN Homecare, LLC is a home care provider that services in Chadds Ford, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
As a trusted non-medical home care provider, HomeCare Instead is committed to providing exceptional personal care assistance. We encourage rehabilitation and independence of our clients, helping them achieve the highest...
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.