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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:
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Jim and Linda Pirog were inspired to open Senior Helpers of Peachtree City in 2006 after a search for home care for a loved one yielded limited options and unreliable services. The Pirogs and their team of staff and...
Continuity of Care INC is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Touching Hearts at Home serves clients throughout Fayette county and the surrounding areas. Our mission is to help seniors and people with disabilities to enhance their quality of life and remain in their own homes for...
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,...
CROWN HEALTH CARE SERVICES, INC is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sunshine Companions is here to help you in your situation. Our Joy is your Good Health and Long Life. We are positioned to Support an Effective, Coordinated Continuum of Care. With the aim to earn trust with our clients /...
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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...
Acti-Kare of Fayetteville provides quality in home care services to families and seniors in Fayetteville, Peachtree City, Whitesburg, Palmetto, Moreland. Our carefully selected and qualified caregivers deliver...
Best Homecare Solutions is continuing to gain the trust of many families because of our dedication to building a legacy of quality and affordable care. You know that your loved one is in the most capable hands for...
BEST HOMECARE SOLUTIONS LLC Duplicate is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Mimi Cares Personal Care is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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.
Ideal Healthcare Providers is more than just your care agency. We can also be your family. In everything we do, we prioritize your wellness, comfort, and satisfaction in every care. We make sure that you receive...
LAIGMINT MEDICAL AND CARE SERVICES LLC is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DIVERSIFIED PRIVATE HOME CARE is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CHERISHED HEARTS PRIVATE HOMECARE, LLC is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
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Bisol Homecare Services offers personalized and compassionate in-home care for seniors and individuals with disabilities. Our skilled caregivers provide assistance with daily activities, medical care, and warm...
Next Level Private Homecare is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Amor Home Care LLC is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
To create an Environment that promotes Independency, while ensuring dignity, respect, & compassion by our dedicated team of healthcare professionals to enhance the quality of life of Senior Citizens & Veterans through...
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ComForCare Home Care - Fayetteville, GA is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
J-M Home Care Services is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Personal Care, Companion, and Sitter Services Our care team can help your loved one with a wide range of personal care needs, allowing them to stay as independent as possible. This can include personal hygiene needs,...
Home Care Inbound is a home care provider that services in Fayetteville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Sunvera Home Care, our team has made it our mission to warmly embrace our clients’ home care needs to ensure that we provide the services they need most.
At SYNERGY HomeCare, we build connections and forward momentum in people’s lives. We call it the Synergy Effect. We believe our purpose is to provide the best care possible. Equally important is helping people feel, see...
FAMILY FIRST HOME AND HEALTHCARE SERVICES, LLC is a home care provider that services in Fayetteville, GA. 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.