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:
Rehoboth Elderly Care and Companionship LLC is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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,...
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...
At SeniCare Plus, we stand out as an exceptional home care services agency, not just fulfilling but exceeding the standards of care. With eight years as a premier boutique agency in the home care sector, we bring a...
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...
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...
House Calls Home Care of Jamaica, NY is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Guiding Light Home Care is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Summit Home Health Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Psb Home Care Agency is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heron Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Links Home Care in Jamaica, NY, is a leading provider of non-medical, live-in or in-home senior home care throughout Long Island, Westchester, Bronx, Manhattan, Brooklyn, and parts of New Jersey. We are honored and...
Essential Care is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caroline Home Health Care Services, Inc. DBA Homecare for the 21st Century is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical...
Lynn Agency, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Love To Care Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Home Health Care Services, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kris Agency And Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allen Health Care Services is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Any-Time Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sweet P Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Personal-Touch Home Care Inc is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heron Home Care of Flushing, NY is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Primary Home Care Services is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Region Care Nursing Agency is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
F & Z Home Care Agency, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Crowne Of Life Care Inc is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Happy Days Home Health Care Services is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Concern Home Care is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Harry's Nurses Registry, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kris Agency & Home Care Inc of Jamaica, NY is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Home Health Care Services, Inc. in Jamaica, NY is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Genevieve Specialty Inc. - We are passionate about providing you with professional and personalized care and will work hard to exceed your expectations. Contact us today and start your journey to healthy and fulfilled...
Perfect Gentle Hands Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Why Home Helpers for In-Home Care? Home Helpers In-Home Care Services 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,...
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...
Finding the proper in-home health care when your loved ones are no longer able to care for themselves is an important part of maintaining a positive lifestyle. Perfect Gentle Hands Home Care Agency provides compassionate...
Rehoboth Elderly Care and Companionship LLC is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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,...
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...
At SeniCare Plus, we stand out as an exceptional home care services agency, not just fulfilling but exceeding the standards of care. With eight years as a premier boutique agency in the home care sector, we bring a...
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...
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...
House Calls Home Care of Jamaica, NY is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Guiding Light Home Care is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Summit Home Health Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Psb Home Care Agency is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heron Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Links Home Care in Jamaica, NY, is a leading provider of non-medical, live-in or in-home senior home care throughout Long Island, Westchester, Bronx, Manhattan, Brooklyn, and parts of New Jersey. We are honored and...
Essential Care is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caroline Home Health Care Services, Inc. DBA Homecare for the 21st Century is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical...
Lynn Agency, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Love To Care Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Home Health Care Services, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kris Agency And Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allen Health Care Services is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Any-Time Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sweet P Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Personal-Touch Home Care Inc is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heron Home Care of Flushing, NY is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Primary Home Care Services is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Region Care Nursing Agency is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
F & Z Home Care Agency, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Crowne Of Life Care Inc is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Happy Days Home Health Care Services is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Concern Home Care is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Harry's Nurses Registry, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kris Agency & Home Care Inc of Jamaica, NY is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Home Health Care Services, Inc. in Jamaica, NY is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Genevieve Specialty Inc. - We are passionate about providing you with professional and personalized care and will work hard to exceed your expectations. Contact us today and start your journey to healthy and fulfilled...
Perfect Gentle Hands Home Care, Inc. is a home care provider that services in Jamaica, NY. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Why Home Helpers for In-Home Care? Home Helpers In-Home Care Services 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,...
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...
Finding the proper in-home health care when your loved ones are no longer able to care for themselves is an important part of maintaining a positive lifestyle. Perfect Gentle Hands Home Care Agency provides compassionate...
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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.