Are you sure you want to exit? Your progress will be lost.
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.*
✔
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:
Prosperous Living Home Health Service, LLC serve clients who need care, monitoring, and oversight as needed, daily, weekly, monthly, or 24/7 in their own home environment. We serve clients of all ages who are diagnosed...
Owner Jay Scripter proudly provides the best in-home care option for seniors in the Lake Norman community. After his mother's severe stroke, Jay opened Senior Helpers with a dedicated team of caregivers committed to...
Caring At Heart began out of a concern for how home care agencies treated their clients and handled their business. Believing that families deserve better than what was being offered, a compassionate and...
Alternative Living Solutions of North Carolina is a Non-Profit outpatient home health company founded by Stephanie Shine-Morrison. We aim to make sure that all of our patients needs are thoroughly taken care of. We offer...
Since 1984, the founders of Preferred Care at Home have had the privilege of assisting clients improve their quality of life while still recognizing and maintaining their dignity and independence. Preferred Care at Home...
Welcome to Home Care Freedom. As a home care provider, we want you to trust us with your personal and health needs. We proudly provide non-medical home care services to individuals with disabilities, injuries,...
At MMJ Home Care Solutions, we believe that everyone deserves to age with dignity, comfort, and respect. As a family-owned, community-driven home care provider, we are dedicated to delivering non-medical support that...
Choosing an in-home senior care provider involves quite a bit of trust, and we don’t take that lightly. Our caregivers are held to the highest standards and carefully screened. You can rest assured that all CareBuilders...
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...
Angelic Home Care, we provide exceptional care so that your loved one has the support they need to enjoy the quality of life they deserve in the place their most comfortable at home. We strive to help people have their...
The Synergy HomeCare Difference... Synergy HomeCare, the most trusted name in non-medical in-home care, stands out from the rest because we provide in-home care and services to all ages from senior adults to children....
We provide assistance to individuals who need help with daily activities due to aging, illness, injury, or disability. Their responsibilities vary depending on the needs of the person they are caring for but generally...
At Family Care Connect, our mission is to empower families by providing compassionate, reliable, and innovative support solutions that enhance the well-being of their loved ones. We are dedicated to fostering strong,...
HomeWell Care Services of Huntersville, NC serves Charlotte, NC and surrounding areas. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
Always Best Care combines national strength and standards with local accessibility and personal service. Joanne Pizzuto, Gina Ward and Andrea Allegretto, the owners of Always Best Care-Winston-Salem, are local residents...
Empowering you to live independently at home. If you love your home and plan to stay right where you are, Aldersgate At Home is the perfect solution for seniors. Created by the most respected Life Plan Community in...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in North Charlotte or in surrounding areas like Huntersville, Harrisburg, or Concord.
The Dudley’s Home Care Team is focused on providing the best care and service humanly possible in a compassionate and dignified manner. Our concern for our customers manifests itself in our belief in “The Golden Rule”....
PACE of the Southern Piedmont is here to help you continue living in the home and community you love. The Program of All-Inclusive Care (PACE) is a Medicare not for profit, Medicaid State option program. We serve...
If you or someone you love needs in-home assistance, contact FirstLight Home Care Greater Charlotte. Whether you’re a senior, a new mother, someone recovering from surgery or you just need extra help, FirstLight Home Care...
Why Affordable Family Care Services? • RN Assessments and Follow up Visits • Caregiver Match • 24-Hour On-Call • Alzheimer’s/Dementia Care Specialists • Licensed-Bonded-Fully Insured • Family Owned and...
Seniors Helping Seniors® 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...
Caring Companion's Home Care, LLC is a home care provider that services in Huntersville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Honest Home Care is a home care provider that services in Huntersville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Griffin In Home Care Services, LLC is a home care provider that services in Huntersville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Acti-Kare of Huntersville, NC is a home care provider that services in Huntersville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Wisdom Senior Care creates sustainable solutions for our seniors and nurturing them in their daily lives in the comfort of their homes is what we envision.
For Gwen and Brad Smith, owners of Amada Senior Care Charlotte, delivering excellence in senior home care is of the utmost priority to each member of their caregiving team. Coming in a close second is providing dedicated...
Experience a Better Way to Age with Gentle Shepherd Care. Gentle Shepherd Care provides At Home Care services in the Charlotte Metro Area, and Eldercare Management and Lifecare Planning services nationwide. Our support...
Prosperous Living Home Health Service, LLC serve clients who need care, monitoring, and oversight as needed, daily, weekly, monthly, or 24/7 in their own home environment. We serve clients of all ages who are diagnosed...
Owner Jay Scripter proudly provides the best in-home care option for seniors in the Lake Norman community. After his mother's severe stroke, Jay opened Senior Helpers with a dedicated team of caregivers committed to...
Caring At Heart began out of a concern for how home care agencies treated their clients and handled their business. Believing that families deserve better than what was being offered, a compassionate and...
Alternative Living Solutions of North Carolina is a Non-Profit outpatient home health company founded by Stephanie Shine-Morrison. We aim to make sure that all of our patients needs are thoroughly taken care of. We offer...
Since 1984, the founders of Preferred Care at Home have had the privilege of assisting clients improve their quality of life while still recognizing and maintaining their dignity and independence. Preferred Care at Home...
Welcome to Home Care Freedom. As a home care provider, we want you to trust us with your personal and health needs. We proudly provide non-medical home care services to individuals with disabilities, injuries,...
At MMJ Home Care Solutions, we believe that everyone deserves to age with dignity, comfort, and respect. As a family-owned, community-driven home care provider, we are dedicated to delivering non-medical support that...
Choosing an in-home senior care provider involves quite a bit of trust, and we don’t take that lightly. Our caregivers are held to the highest standards and carefully screened. You can rest assured that all CareBuilders...
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...
Angelic Home Care, we provide exceptional care so that your loved one has the support they need to enjoy the quality of life they deserve in the place their most comfortable at home. We strive to help people have their...
The Synergy HomeCare Difference... Synergy HomeCare, the most trusted name in non-medical in-home care, stands out from the rest because we provide in-home care and services to all ages from senior adults to children....
We provide assistance to individuals who need help with daily activities due to aging, illness, injury, or disability. Their responsibilities vary depending on the needs of the person they are caring for but generally...
At Family Care Connect, our mission is to empower families by providing compassionate, reliable, and innovative support solutions that enhance the well-being of their loved ones. We are dedicated to fostering strong,...
HomeWell Care Services of Huntersville, NC serves Charlotte, NC and surrounding areas. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
Always Best Care combines national strength and standards with local accessibility and personal service. Joanne Pizzuto, Gina Ward and Andrea Allegretto, the owners of Always Best Care-Winston-Salem, are local residents...
Empowering you to live independently at home. If you love your home and plan to stay right where you are, Aldersgate At Home is the perfect solution for seniors. Created by the most respected Life Plan Community in...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in North Charlotte or in surrounding areas like Huntersville, Harrisburg, or Concord.
The Dudley’s Home Care Team is focused on providing the best care and service humanly possible in a compassionate and dignified manner. Our concern for our customers manifests itself in our belief in “The Golden Rule”....
PACE of the Southern Piedmont is here to help you continue living in the home and community you love. The Program of All-Inclusive Care (PACE) is a Medicare not for profit, Medicaid State option program. We serve...
If you or someone you love needs in-home assistance, contact FirstLight Home Care Greater Charlotte. Whether you’re a senior, a new mother, someone recovering from surgery or you just need extra help, FirstLight Home Care...
Why Affordable Family Care Services? • RN Assessments and Follow up Visits • Caregiver Match • 24-Hour On-Call • Alzheimer’s/Dementia Care Specialists • Licensed-Bonded-Fully Insured • Family Owned and...
Seniors Helping Seniors® 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...
Caring Companion's Home Care, LLC is a home care provider that services in Huntersville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Honest Home Care is a home care provider that services in Huntersville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Griffin In Home Care Services, LLC is a home care provider that services in Huntersville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Acti-Kare of Huntersville, NC is a home care provider that services in Huntersville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Wisdom Senior Care creates sustainable solutions for our seniors and nurturing them in their daily lives in the comfort of their homes is what we envision.
For Gwen and Brad Smith, owners of Amada Senior Care Charlotte, delivering excellence in senior home care is of the utmost priority to each member of their caregiving team. Coming in a close second is providing dedicated...
Experience a Better Way to Age with Gentle Shepherd Care. Gentle Shepherd Care provides At Home Care services in the Charlotte Metro Area, and Eldercare Management and Lifecare Planning services nationwide. Our support...
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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.