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:
Serenity Care and Compassion is Locally Operated, Licensed, Bonded, Insured, and have been providing compassionate care in Georgia For 15+ Years and are happy to provide services to older adults and children in need of...
North Georgia’s premier home health company, where we specialize in personalized care solutions for individuals in need. Our dedicated team views themselves as an extended support system for clients and their families,...
At EMIC HEALTHCARE, we started with a simple idea: to provide reliable and compassionate home health care services to those in need. We are a licensed private home care service agency in Georgia destined to be a trusted...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Seniors Helping Seniors® 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...
From delivering specialized home care to managing everyday tasks, or simply keeping your loved one company, we’ll work with you to develop a custom home care plan that compassionately responds to your loved one’s needs,...
Acti-Kare is a leading in-home senior care company that has been trusted for over a decade. Our caregivers are insured, bonded, and trained which means you will receive a trusted and professional caregiver every time....
Hearts of Love Caregivers helps families with non-medical in home care. We offer in home health care in select locations. With Hearts of Love Caregivers, every client receives extra ordinary care from our caring team. We...
Certified Home Care of Georgia LLC is a trusted provider of high-quality, compassionate home care services across Georgia. With a team of highly trained and certified professionals, the company is dedicated to delivering...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Jojo Home Care Services, Compassionate In-Home Care Services At Jojo Home Care Services, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence....
You can be confident that all of our caregivers are State licensed Certified Nursing Assistants, well trained in the diseases of the elderly, highly experienced in critical areas of need and have passed a complex...
Sahara Georgia Home Care LLC offers compassionate, personalized home care services to individuals in Georgia, ensuring comfort and support in their own homes with a focus on enhancing the quality of life for both patients...
Our caregivers assist with activities of daily living such as bathing, dressing, grooming, and medication reminders, promoting personal hygiene and overall wellness.
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We our licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Home Instead Snellville offers individualized in-home senior care right in your neighborhood. Our trained, screened and bonded CAREGivers are serving Georgia communities with compassion and devotion.
Senior Solutions is a non-medical comprehensive home care agency that trains caregivers who assist our clients with activities of daily living in their own homes. In recent years, we have also added service lines to help...
SYNERGY HomeCare of North Atlanta, GA is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Georgia Peachcare Service provides personalized, high-quality home care services to seniors and individuals with disabilities. Our dedicated caregivers offer assistance with daily activities, companionship, and support to...
Charlotte Web Private Home Care, LLC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home is North Atlanta's trusted quality in-home senior care provider. We create custom care plans as needs change to allow your family members to live at home as long as possible.
Bloom Rock Care was founded with a passion for providing high quality in-home care services to seniors and individuals with disabilities. Our founders recognized the need for personalized, compassionate care that is...
Welcome to Flamede health! We provide efficient, effective, comforting and loving short-term and long-term in-home care. We are here to care for the needs of your loved ones from Pediatric to elderly & disabled. We...
Azalea Home Care provides compassionate and personalized in-home care services. Our dedicated caregivers assist with daily tasks, ensuring comfort, safety, and independence while enhancing the quality of life for seniors...
ABC Home Care Services, LLC stands out as the premier choice for those seeking compassionate and reliable home care. With a dedicated team of trained professionals, we prioritize the well-being and comfort of our clients...
Nightingales Home Care Services is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARE PLUS, INC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nurturing Caregivers In-Homecare LLC is a reliable provider of home care in Duluth, Georgia that serves seniors, people with disabilities, and individuals who are recovering from a severe injury or illness. We strive to...
Gees Hope Caring Agency - Duluth, GA is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Dependable Homecare LLC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Home Nursing prides itself on having a dedicated and passionate team that will strive to deliver a sense of compassion, awereness, safety, and exceptional skilled and personal in home care to our clients. Why...
Safe Space Healthcare LLC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
River Oaks Healthcare System, Inc. is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Denhavens PCH, Inc is a home care provider serving Duluth, GA 30096. Our services enable seniors to stay safely in their homes while receiving medical care or assistance with personal tasks. While service offerings vary,...
1st Option Health Care LLC, GA is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Miryam Loving Care, LLC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Grace Homecare Service is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Lois Comfort Home Care is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In Sricare we distinguish ourselves through our commitment to personalized care and respect for each client's unique needs. Our caregivers are dedicated to tailoring their services to provide the highest standard of...
MainSpring Home Care is committed to providing high-quality, affordable, and compassionate Private Home Care Services that meet the needs of our clients and their loved ones in the comfort of their own homes.
At Home Matters Caregiving of North Atlanta, we provide homecare that strives to keep our clients as independent as possible; improving quality of life, longevity and provide peace of mind.
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...
At Amada Senior Lake Lanier, we get to know the seniors we work with so we can provide an enriching care experience. We go beyond the typical caregiver tasks with personal touches that brighten the days of our clients. We...
Serenity Care and Compassion is Locally Operated, Licensed, Bonded, Insured, and have been providing compassionate care in Georgia For 15+ Years and are happy to provide services to older adults and children in need of...
North Georgia’s premier home health company, where we specialize in personalized care solutions for individuals in need. Our dedicated team views themselves as an extended support system for clients and their families,...
At EMIC HEALTHCARE, we started with a simple idea: to provide reliable and compassionate home health care services to those in need. We are a licensed private home care service agency in Georgia destined to be a trusted...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Seniors Helping Seniors® 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...
From delivering specialized home care to managing everyday tasks, or simply keeping your loved one company, we’ll work with you to develop a custom home care plan that compassionately responds to your loved one’s needs,...
Acti-Kare is a leading in-home senior care company that has been trusted for over a decade. Our caregivers are insured, bonded, and trained which means you will receive a trusted and professional caregiver every time....
Hearts of Love Caregivers helps families with non-medical in home care. We offer in home health care in select locations. With Hearts of Love Caregivers, every client receives extra ordinary care from our caring team. We...
Certified Home Care of Georgia LLC is a trusted provider of high-quality, compassionate home care services across Georgia. With a team of highly trained and certified professionals, the company is dedicated to delivering...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Jojo Home Care Services, Compassionate In-Home Care Services At Jojo Home Care Services, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence....
You can be confident that all of our caregivers are State licensed Certified Nursing Assistants, well trained in the diseases of the elderly, highly experienced in critical areas of need and have passed a complex...
Sahara Georgia Home Care LLC offers compassionate, personalized home care services to individuals in Georgia, ensuring comfort and support in their own homes with a focus on enhancing the quality of life for both patients...
Our caregivers assist with activities of daily living such as bathing, dressing, grooming, and medication reminders, promoting personal hygiene and overall wellness.
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We our licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Home Instead Snellville offers individualized in-home senior care right in your neighborhood. Our trained, screened and bonded CAREGivers are serving Georgia communities with compassion and devotion.
Senior Solutions is a non-medical comprehensive home care agency that trains caregivers who assist our clients with activities of daily living in their own homes. In recent years, we have also added service lines to help...
SYNERGY HomeCare of North Atlanta, GA is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Georgia Peachcare Service provides personalized, high-quality home care services to seniors and individuals with disabilities. Our dedicated caregivers offer assistance with daily activities, companionship, and support to...
Charlotte Web Private Home Care, LLC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home is North Atlanta's trusted quality in-home senior care provider. We create custom care plans as needs change to allow your family members to live at home as long as possible.
Bloom Rock Care was founded with a passion for providing high quality in-home care services to seniors and individuals with disabilities. Our founders recognized the need for personalized, compassionate care that is...
Welcome to Flamede health! We provide efficient, effective, comforting and loving short-term and long-term in-home care. We are here to care for the needs of your loved ones from Pediatric to elderly & disabled. We...
Azalea Home Care provides compassionate and personalized in-home care services. Our dedicated caregivers assist with daily tasks, ensuring comfort, safety, and independence while enhancing the quality of life for seniors...
ABC Home Care Services, LLC stands out as the premier choice for those seeking compassionate and reliable home care. With a dedicated team of trained professionals, we prioritize the well-being and comfort of our clients...
Nightingales Home Care Services is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARE PLUS, INC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nurturing Caregivers In-Homecare LLC is a reliable provider of home care in Duluth, Georgia that serves seniors, people with disabilities, and individuals who are recovering from a severe injury or illness. We strive to...
Gees Hope Caring Agency - Duluth, GA is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Dependable Homecare LLC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Home Nursing prides itself on having a dedicated and passionate team that will strive to deliver a sense of compassion, awereness, safety, and exceptional skilled and personal in home care to our clients. Why...
Safe Space Healthcare LLC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
River Oaks Healthcare System, Inc. is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Denhavens PCH, Inc is a home care provider serving Duluth, GA 30096. Our services enable seniors to stay safely in their homes while receiving medical care or assistance with personal tasks. While service offerings vary,...
1st Option Health Care LLC, GA is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Miryam Loving Care, LLC is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Grace Homecare Service is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Lois Comfort Home Care is a home care provider that services in Duluth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In Sricare we distinguish ourselves through our commitment to personalized care and respect for each client's unique needs. Our caregivers are dedicated to tailoring their services to provide the highest standard of...
MainSpring Home Care is committed to providing high-quality, affordable, and compassionate Private Home Care Services that meet the needs of our clients and their loved ones in the comfort of their own homes.
At Home Matters Caregiving of North Atlanta, we provide homecare that strives to keep our clients as independent as possible; improving quality of life, longevity and provide peace of mind.
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...
At Amada Senior Lake Lanier, we get to know the seniors we work with so we can provide an enriching care experience. We go beyond the typical caregiver tasks with personal touches that brighten the days of our clients. We...
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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.