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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.*
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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:
We provide a wide range of services, including in-home care, companionship, personal assistance, and specialized support for seniors with Alzheimer’s, dementia, and other health conditions. Our team of trained caregivers...
At Helping Wings, we provide compassionate self-care assistance, reliable household support, and friendly companionship—giving you and your loved ones peace of mind. Our caregivers undergo rigorous evaluations, ongoing...
Where compassionate care meets unwavering dedication. We are more than just a healthcare service provider—we are a family committed to delivering exceptional, personalized services that enhance the well-being of our...
Our goal is to promote independence for our clients by providing compassionate care in the comfort of their homes. patient Often individuals require assistance with one or more of their activities of daily living such...
Home Helpers Home Care of South Bergen County is more than an in-home health care agency – we’re your extended family when family can’t be there. We’re a locally owned, trusted provider of quality, compassionate in-home...
Serving Eastern Bergen County, NJ, Interim HealthCare of Englewood is proud to raise the bar in home healthcare, hiring only the most experienced and best qualified care providers to serve our clients. Our foundational...
When we started LifeWorx in 2004, we wanted to build more than caring, empathetic care services. We wanted to build a community of giving. A place you join as an individual, ‘me’, but where you become part of a greater...
Best Home Care in Bergen County At SYNERGY HomeCare of Bergen County, NJ our mission is to be your premier provider of in- home care services by always striving to offer your senior parent or family member the highest...
Comfort Keepers of Montclair, NJ is a home care provider that services in Fort Lee, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Grace Total Homecare Services, LLC is a compassionate and reliable provider of in-home healthcare solutions, dedicated to enhancing the quality of life for individuals in need of personalized care.
Our mission is to support the health and well-being of our clients by delivering the finest personalized in-home care, specific to their needs, wants and preferences
We provide outstanding care, which is always delivered with kindness and respect. We know that to consistently offer a high quality service, we need to employ great staff. We only recruit highly experienced and...
Exclusive Care is a home care provider that services in Fort Lee, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Dahlias Home Care Agency LLC is a home care provider that services Fort Lee, NJ 07024. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
Bonjour Home Care is a home care provider that services in Fort Lee, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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,...
We understand that a leap of faith is often involved when family members consider home care for their love ones. While many families hope for the best, we do not believe in leaving home care to chance. Best Home Care is...
Eastbridge Home Care is a home care provider that services in Fort Lee, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Helping Hand is a state licensed agency that specializes in providing personalized, in-home care to the elderly and anyone who wishes to remain independent in their own homes for as long as possible. Locally owned and...
Dahlias Home care Agency is the trusted home care agency in Fort Lee. Since 2024, we’ve been serving the senior population and those of vulnerable. Your loved ones deserve the best when it comes to their home care...
Amorycare Homecare was created based on the idea that forming a family-like bond between caregiver and client is the key to providing New Jersey families with the highest quality home health care experience. Amorycare...
2nd Family of Northern NJ is a home care provider that services in Fort Lee, NJ. 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.