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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:
Right at Home of St. Louis and St. Charles provides personalized in-home care and support and specialized nursing services for seniors and adults with disabilities in greater St. Louis, St. Charles and surrounding...
Tender Touch Home Health Care provides compassionate, personalized support to help clients stay safe, independent, and comfortable at home. We work closely with each individual and their family to create custom care plans...
Welcome to Personalized Home Healthcare Services, LLC and thank you for your interest in our company. Personalized HHC, LLC is an in-home care provider of home care services and we've been in the private home care...
Majestic Home Health Care of Florissant, MO is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We Care With Love Home Health, LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Mother's Touch In-home Health Care is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Purpose Hm Care Svc LLC of Florissant, MO is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
EASY CARE CONSUMER DIRECTED SERVICES LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AGAPE LOVE HOME HEALTHCARE LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TOTAL ASSISTANCE TO THE ELDERLY LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heavenly Angels Home Healthcare Services of Florissant, MO is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Intentional nurse consulting is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Precious Palms Home Services LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our vision is to be Missouri’s leading home care provider, known for setting the standard in compassionate, client-centered care. We strive to create a future where every individual in need of assistance can age with...
Care Now Health Service LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
PREDICTIVE NEEDS HEALTHCARE SERVICES LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Since 1989, Mother’s Way Child and Adult Care Center, Inc. has been a trusted source of compassionate, reliable care for families across our community. As a licensed home care agency, we proudly provide personal and...
All About Love and Care of St. Louis, MO is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ADMINICARE is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
N&D Home Health Care is a home care provider that services Florissant, MO 63033. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and other...
ROYAL TOUCH HOME HEALTH LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Eminent Home Care LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TKB Care Home Care is an outstanding provider of personal and skilled care services in the St. Louis, Missouri area. Founded by a registered nurse, the agency is deeply committed to meeting the full spectrum of clients’...
Heavenly Angels Home Care is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Iconic Health Agency is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heart 2 Heart Home Care of Florissant, MO is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Harmony Home Care LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Anointed Hands Home Care Services LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Living Healthier Home Healthcare LLC is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
JCL In Home Health Care is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ER Home Health is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angels Of Mercy Healthcare, Inc is a home care provider that services in Florissant, MO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Moments Home Health Llc is a home care provider that services in Florissant, MO. 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.