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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:
We’re here to help you continue living independently. If you or a loved one is having trouble with activities of daily living, home safety or personal care, we can provide a specialized program to make life easier and...
Herewith, Inc. is a nationwide platform connecting families with experienced, background-checked caregivers for non-medical in-home care, including in Michigan. Their services encompass assistance with light housekeeping,...
Genesis Homecare Services believes that everyone, especially our seniors, deserves joy and comfort in their lives. Our unique business combines the delight of sweet treats with a commitment to providing exceptional senior...
Senior Care with a Full Satisfaction Guarantee - At HomeWell of Oakland County, we are proud to deliver in-home and hourly care services for seniors who wish to remain in the comfort of their own homes—whether they live...
Welcome to Cornerstone Caregiving. We are a senior in-home care service that allows your loved ones to stay where they feel most comfortable: home. We are experienced senior care professionals who are willing and ready to...
At Precious Gift Home Healthcare Agency LLC, we believe that quality care is the foundation of a fulfilling life. Our mission is to provide compassionate, personalized, and professional home healthcare services that...
Dynamic Care Services, Llc of Dearborn, MI is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
American Choice Home Health, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advance Home Health Care Services, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comprehensive Home Health Care Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Infinity Home Health Services, Pc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Accessible Home Care, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Metro Home Health Care Plans is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Providers Home Care, LLC is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Al- Hoda Home Care Services, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
WiserCare Home Care is a local agency that was built on integrity, love, kindness, and compassion. We are dedicated to being involved in the care of your loved one and fully committed to improve the lives of our clients,...
Amber Home Health Care, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ultimate Home Care, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Armantii Home Care Services was founded with a passion for providing high-quality home health care services to seniors and individuals with disabilities. Our founder, who has over 20 years of experience in the healthcare...
Access Home Health Care, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
B & B Senior Services of MI LLC is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alpha Home Care Services, Inc is a home care provider that services in Dearborn, MI. 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,...
Fairlane Home Health Care, L L C is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Life Line Home Health, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Nursing Care, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homecare Alliance Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Five Star Home Health Care, L L C is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ascention Home Health Services, Ltd is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Transition Home Health Partners, L L C is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Brighter Pathways LLC is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Link Home Health Care, Inc is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home - Dearborn/Downriver, MI is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Synergy Home Health System, L L C is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comfort Care Home Care Assistance - Grosse Pointe is a home care provider that services in Dearborn, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance 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.