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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.*
✔
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:
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...
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...
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,...
Senior Helpers - Gastonia, NC is a home care provider that services in Mount Holly, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Choosing the proper home care agency for yourself or a senior loved one is something most people are not prepared for, but Amada Senior Care of West Charlotte is here to show you the way. Korey Sixbury, owner of Amada...
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...
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...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in West Charlotte or in surrounding areas like Belmont, Stanley, or Bessemer City.
We all want the best care for our aging loved ones, but getting that care can be frustrating. If you have an aging loved one, you know what it’s like to drive them from appointment to appointment; manage their medications...
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...
Caring for a loved one who needs assistance at home can be emotionally and physically challenging. That's where Home Helpers Home Care of Belmont comes into the picture. Our experienced Caregivers are here to help, so you...
Touched By Angels Home Health - PHC is a home care provider that services in Mount Holly, 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.
Senior Helpers Charlotte is the premier provider of in-home senior care. We offer tailored home care services ranging from companion care for seniors who need daily assistance to in-depth specialized care for those with...
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...
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...
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...
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,...
Senior Helpers - Gastonia, NC is a home care provider that services in Mount Holly, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Choosing the proper home care agency for yourself or a senior loved one is something most people are not prepared for, but Amada Senior Care of West Charlotte is here to show you the way. Korey Sixbury, owner of Amada...
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...
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...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in West Charlotte or in surrounding areas like Belmont, Stanley, or Bessemer City.
We all want the best care for our aging loved ones, but getting that care can be frustrating. If you have an aging loved one, you know what it’s like to drive them from appointment to appointment; manage their medications...
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...
Caring for a loved one who needs assistance at home can be emotionally and physically challenging. That's where Home Helpers Home Care of Belmont comes into the picture. Our experienced Caregivers are here to help, so you...
Touched By Angels Home Health - PHC is a home care provider that services in Mount Holly, 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.
Senior Helpers Charlotte is the premier provider of in-home senior care. We offer tailored home care services ranging from companion care for seniors who need daily assistance to in-depth specialized care for those with...
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.