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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.
✔
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:
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Whether you need Senior Helpers' assistance 24/7 or just a few hours a day, our offices are here to help with flexible service options. We provide professional and compassionate in-home care so that our seniors can age...
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We are a dedicated homecare services provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity.
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Caring for your aging parents or a family member recovering from recent illness or surgery can be exhausting, lonely work. Thousands of families go through this type of struggle every year, but you can find comfort and...
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Innovative Homecare Solutions We all need help, be it little or big, from time to time. And, while a lot of seniors or elderly individuals or seniors seek support from their family and friends, there may be many...
Midwest Healthcare Providers, Inc is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a premier home healthcare provider for people in and around Chicago that provides compassionate assistance with personalized care and attention in your preferred residence. The founder discovered a need to provide...
Jennifer Novy, owner of Amada Senior Care North Shore, has dedicated her professional and personal life to caring for seniors. As a life-long Chicagoan, she now uses her senior care experience to help neighbors in Lake...
Senior Helpers of Greater Chicagoland 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...
Growing up in the house “on the corner” was truly special. Mom cared not only for our family, but for the whole neighborhood. When Alzheimer’s knocked at her door, our family answered the call to care for her the way she...
Assistance Home Care Downers Grove is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Looking for quality home care services? Look no further! Senior Helpers of Bolingbrook offers 1 hour to 24/7 live-in care with no minimum hours and competitive rates. Our senior care services include same-day intakes,...
APEX Health Services comprises a team of experts who redefine the continuum of health care model for optimal patient outcomes. We are committed to innovative care models that provide a full spectrum of services evolving...
Home & Hearth Caregivers is available 24/7 for you or your loved one. We serve Cook, DuPage, Kane, Kendall, Lake, McHenry and Will counties. Our experienced Care Plan Managers will be happy to provide a complimentary home...
Our team of compassionate and empathetic caregivers is committed to delivering care with a heart! They undergo rigorous training and background checks to ensure they are qualified to provide the care you need. We...
Whether you need Senior Helpers' assistance 24/7 or just a few hours a day, our offices are here to help with flexible service options. We provide professional and compassionate in-home care so that our seniors can age...
At FirstLight Home Care of Oak Brook, we provide exceptional care so that your loved one has the support they need to enjoy the quality of life they deserve in the place they call home. We exist to help people have...
Samaritan Senior Care is a licensed elderly home care provider with over ten years of experience. Our compassionate caregivers assist elders in maintaining independence and offer comfort to family members who might...
We are a dedicated homecare services provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity.
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Entera HomeCare, LLC is a dedicated provider of comprehensive home care services designed to meet the unique needs of individuals in the comfort and familiarity of their homes.
Caring for your aging parents or a family member recovering from recent illness or surgery can be exhausting, lonely work. Thousands of families go through this type of struggle every year, but you can find comfort and...
Home Instead of Lisle, IL is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Harvest In-HomeCare Inc. - Plainfield, IL is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In 2019 Susie Murphy started D’Vine Caregivers as a natural extension of her 35 years of excellence in matching nannies and domestic helpers with young families. She now brings her skills and insight in finding and...
Eno Home Care is a dedicated home care agency committed to providing high-quality, compassionate, and personalized care for seniors and individuals with disabilities.
Leverage Home Care Services offers compassionate companion care to enhance well-being through emotional support and social interaction. Our caregivers provide meaningful conversations, accompany clients on transitions,...
Larlin Health Care, Inc is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Model Home Health Care Inc is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advocate Home Health Care Serv is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Essential Home Care, Inc is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Life Care Home Health Services Corporation is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Did you know 75% of those who fall do so again within 6 months. Concerned about FALLS, Medication ERRORS and Home SAFETY. Assisting Hands has local experts in Fall Prevention (Fall Prevention Clinics of America),...
Reliacare Ltd is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DUPE Home Helpers Home Care of Downers Grove, IL is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Innovative Homecare Solutions We all need help, be it little or big, from time to time. And, while a lot of seniors or elderly individuals or seniors seek support from their family and friends, there may be many...
Midwest Healthcare Providers, Inc is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a premier home healthcare provider for people in and around Chicago that provides compassionate assistance with personalized care and attention in your preferred residence. The founder discovered a need to provide...
Jennifer Novy, owner of Amada Senior Care North Shore, has dedicated her professional and personal life to caring for seniors. As a life-long Chicagoan, she now uses her senior care experience to help neighbors in Lake...
Senior Helpers of Greater Chicagoland 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...
Growing up in the house “on the corner” was truly special. Mom cared not only for our family, but for the whole neighborhood. When Alzheimer’s knocked at her door, our family answered the call to care for her the way she...
Assistance Home Care Downers Grove is a home care provider that services in Downers Grove, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Looking for quality home care services? Look no further! Senior Helpers of Bolingbrook offers 1 hour to 24/7 live-in care with no minimum hours and competitive rates. Our senior care services include same-day intakes,...
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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.