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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:
PACE of the Southern Piedmont is here to help you continue living in the home and community you love. The Program of All-Inclusive Care (PACE) is a Medicare not for profit, Medicaid State option program. We serve...
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...
Home—there’s no place like it. It’s where your memories are. Where you raised your family and where friends have gathered for life’s celebrations. It’s been your basecamp through good times and bad. And it’s where you...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
HomeWell Care Services of Huntersville, NC serves Charlotte, NC and surrounding areas. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
Why Affordable Family Care Services? • RN Assessments and Follow up Visits • Caregiver Match • 24-Hour On-Call • Alzheimer’s/Dementia Care Specialists • Licensed-Bonded-Fully Insured • Family Owned and...
At Family Care Connect, our mission is to empower families by providing compassionate, reliable, and innovative support solutions that enhance the well-being of their loved ones. We are dedicated to fostering strong,...
Advanced Home Care is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homewatch CareGivers of Concord, NC is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Charlie's Angels Home Health Care Agency is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Central Carolina Home Care is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Victorious Health Services is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kimberly L. McLendon is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Raising Care Services and Staffing, LLC is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Milestone Family Services we work with adults who, due to disabilities or complex medical conditions, need assistance with daily living activity skills that allow them to function at home.
Living Well Senior Care, Inc. Trained in Compassion, Living Well provides specialized comprehensive personal, emotional and cognitive care programs for older adults.
At Top Angels Home Health Agency, we provide a wide range of home healthcare services to clients throughout our area. Our staff goes above and beyond to ensure you get the best quality care possible and is committed to...
Cabarrus Health Alliance/Home is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We provide assistance to individuals who need help with daily activities due to aging, illness, injury, or disability. Their responsibilities vary depending on the needs of the person they are caring for but generally...
Always caring homecare is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kids on Clouds, LLC is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nicholas Walker is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Avid Wellness Counseling and Consulting Inc. is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Rightcare Home Health Services, LLC is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
4C Home Care Services is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
Every day, our expert team of Greater Home Health Services Nurses, and Home Health Aides provide quality care to people of every age and stage of life. We do not make life, but we help make life worth living!
Since 1975, Bayada Nurses has helped people have a safe home life with comfort, independence, and dignity. Bayada Nurses provides skilled, rehabilitative, therapeutic, and personal home health care services to children,...
"Absolutely Divine" Home Care Agency, Inc., (ADHCA) and is Dedicated In Various Individuals Needing Excellent "DIVINE care". ADHCA, Inc. has well over 25 year of exceptional nursing experience. By providing an array of...
Our home healthcare services allow you or your loved one to continue to live independently at home. Our years of experience make it possible for us to deliver outstanding home care services, help create a safe and...
The 4C Company of NC is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Just Like Family is a family-oriented, respect and dignity-based agency; our caregiving began with our very own loved one's. While providing care to our own family, our hearts swelled with the desire to give care to...
Precise Home Care Services, LLC is a home care provider that services in Concord, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We understand that selecting a home care agency can be a difficult decision. We are here to provide you with information and answer any questions you may have to make an informed decision. Our team of experienced...
Quality caregivers and medical staffing solutions in Gaston County At BrightStar Care Northern Charlotte/Huntersville we provide quality home care, caregivers, and medical staffing solutions to families and businesses...
Our goal is to help our clients remain independent at home for as long as possible. However, we understand that most people do not have unlimited funds to pay for respite care. There are several options available to help...
At Senior Helpers, we are dedicated to providing unwavering support in every way possible—no task is too big or too small. I’m Supriya Kulkarni, the proud owner of Senior Helpers of Waxhaw-Monroe, with 25 years of...
Senior Helpers Charlotte is the premier provider of in-home senior care. We offer tailored home care services ranging from companion care for seniors who need daily assistance to in-depth specialized care for those with...
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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.