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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:
Feel better in the comfort of your own home. We specialize in care and daily living assistance to an array of individuals. Whether you need daily or weekly assistance due to aging, illness, recovery, or rehabilitation,...
ProLife Home Care is a woman owned company operating as a New York State Department of Health Licensed Home Care Services Agency (LHCSA) and a New York State Medicaid Lead Fiscal Intermediary administering the Consumer...
Alvita Care is a leading home care provider in New York City, Westchester, Long Island, and New Jersey. We’re best known for in-home senior care, but our caregivers are available to people of all ages, physical...
Life at home becomes more challenging as we age. Care At Home of New York is dedicated to providing seniors, the differently abled, and those with special needs with the help and support they need so they can continue to...
Affinity home care is a private concierge agency. We provide a selection of services based on expert-level care for your loved one. As a boutique agency, we are deeply committed to providing exceptional, elevated care...
Gentle Hands Home Care, LLC offers a wide range of home care services that are dedicated to help improve the quality of life and the health of your loved one at home. We respect and support our clients to stay at home and...
7 Day Home Care provides the same level of care that we demand for our own family. We are family-owned and have helped hundreds of clients since our inception. Our compassionate team of skilled professionals develops...
Rehoboth Elderly Care and Companionship LLC is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance the quality...
The quality of healthcare lies in the caliber and commitment of health professionals. For this reason, we make sure that our therapists are equipped with the practical knowledge and experience in assisting individuals...
Friends For Life HomeCare & Medicaid Consultants in Massapequa, NY, provides compassionate and comprehensive in-home care services tailored to meet the unique needs of individuals and families. They specialize in...
Rite Choice Home Care Agency, Inc. is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
New Century Home Care, Inc. is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bestcare, Inc. is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Unlimited Care, Inc. is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our full-range of home care services enable our clients to live healthier, happier and more rewarding lives in the privacy, safety, and comfort of their own homes. If necessary, our caregivers are also able to care for...
Caring People of Flushing, NY is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Recco Home Care Services, Inc. is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Care Services We have Home Care Solutions to suit every family, situation, and budget. We work with you every step of the way to find the best solution. >CDPAP >Certified Home Health Aides >Private Pay Home...
Ameristar Homecare Services LLC is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Anytime Home Care Inc is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Continental Home Care is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Criticare Helping Hands, Llc is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Better Home Health Care of Forest Hills, NY is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We care where you are. Elara Caring delivers exceptional personalized in-home care services by hiring compassionate people who believe in taking care of our patients, our clients, our care providers and each other. We...
New Millennium Ny, Inc. is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Professionals, Inc. is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mzl Home Care Agency, Llc is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Better Home Health Care Agency is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Best Senior Home Care provides non-medical companion services to seniors in their own home. We can provide companions for a few hours a day, several days a week, or as many hours a day as you require, including live-in...
Galaxy Home Care is a company with deep roots in home health care. Our management team and staff have decades of home health care experience so that we can provide the full range of in-home care services to individuals...
Elder Home Care - Queens, NY is a home care provider that services in Forest Hills, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home Great Neck provides a range of in-home care options for seniors and adults with disabilities. Don’t think of our services as one-size-fits all. We know everyone’s needs are different, so our care plans are...
WHY US? Love and Care LLC offers quality homecare including homemakers, health aides and companions. We screen compassionate and capable caregivers who can play a critical role in delivery of exceptional home health...
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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.