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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:
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Helping People through Home Care in Denver South Do you or a member of your family need in-home assistance? FirstLight Home Care offers one-of-a-kind care services by professional caregivers throughout South Denver...
Our team makes loved ones feel confident and dignified while allowing them to maintain their independence. We provide personal care services, which allows you to spend more quality time together. ACASA Colorado...
At HomeWell Care Services, we provide live-in and hourly at-home care for seniors, the elderly and others who are struggling to manage day-to-day activities like grooming, bathing, cooking, or even running errands. Our...
Kingdom Management Home Care is a purpose-driven company that is ready to serve the disabled and the elderly. We offer a wide array of personalized home care services to assist disabled individuals, the elderly, the...
ACASA Senior Care - Denver, CO is a home care provider that services in Highlands Ranch, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Assisting Hands Home Care of Littleton, CO is a home care provider that services in Highlands Ranch, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At AmeriCARE Denver we believe that all people deserve to live and thrive in the comfort of their own homes, wherever they call home. We understand the complications that come with aging, surgery recovery, and managing...
A Place at Home - South Denver is a dedicated homecare agency providing compassionate and professional in-home care services tailored to the unique needs of each client. Serving the South Denver area, the agency offers a...
No matter their needs, our personalized in-home health care services help your loved one remain where they feel safe and help them actively engage in leading an enriched life.
A Better Solution In Home Care has been helping individuals and families with their care needs since 2000. We have a full service staff available 24 hours per day, 7 days per week. Our staff are experienced, professional,...
5280 Home Care Services, Compassionate In-Home Care Services At 5280 Home Care Services, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence....
Cornerstone Caregiving combines home care with a personal touch, ensuring that your love ones are treated with respect and compassion. Our team of skilled caregivers and supportive office staff provides empathetic,...
Senior Helpers - Littleton, CO is a home care provider that services in Highlands Ranch, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Talem Home Care - Denver, CO is a home care provider that services in Highlands Ranch, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
FirstLight Home Care of Denver Southwest offers complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just needs a little assistance. And with our trusted,...
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...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Helping People through Home Care in Denver South Do you or a member of your family need in-home assistance? FirstLight Home Care offers one-of-a-kind care services by professional caregivers throughout South Denver...
Our team makes loved ones feel confident and dignified while allowing them to maintain their independence. We provide personal care services, which allows you to spend more quality time together. ACASA Colorado...
At HomeWell Care Services, we provide live-in and hourly at-home care for seniors, the elderly and others who are struggling to manage day-to-day activities like grooming, bathing, cooking, or even running errands. Our...
Kingdom Management Home Care is a purpose-driven company that is ready to serve the disabled and the elderly. We offer a wide array of personalized home care services to assist disabled individuals, the elderly, the...
ACASA Senior Care - Denver, CO is a home care provider that services in Highlands Ranch, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Assisting Hands Home Care of Littleton, CO is a home care provider that services in Highlands Ranch, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At AmeriCARE Denver we believe that all people deserve to live and thrive in the comfort of their own homes, wherever they call home. We understand the complications that come with aging, surgery recovery, and managing...
A Place at Home - South Denver is a dedicated homecare agency providing compassionate and professional in-home care services tailored to the unique needs of each client. Serving the South Denver area, the agency offers a...
No matter their needs, our personalized in-home health care services help your loved one remain where they feel safe and help them actively engage in leading an enriched life.
A Better Solution In Home Care has been helping individuals and families with their care needs since 2000. We have a full service staff available 24 hours per day, 7 days per week. Our staff are experienced, professional,...
5280 Home Care Services, Compassionate In-Home Care Services At 5280 Home Care Services, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence....
Cornerstone Caregiving combines home care with a personal touch, ensuring that your love ones are treated with respect and compassion. Our team of skilled caregivers and supportive office staff provides empathetic,...
Senior Helpers - Littleton, CO is a home care provider that services in Highlands Ranch, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Talem Home Care - Denver, CO is a home care provider that services in Highlands Ranch, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
FirstLight Home Care of Denver Southwest offers complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just needs a little assistance. And with our trusted,...
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...
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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.