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:
At Amada Chester County, we strive to provide the highest quality of care with a sense of warmth, kindness and compassion. Each member of our team is committed to your loved one because to us, they are family. We take...
We offer compassionate, personalized home care and mental health coaching tailored to the unique needs of each individual. From senior care to support for children with Autism or ADHD, we create a nurturing environment...
A Ray of Sunshine is a Private Home Care Agency. We designed a well-rounded program that encourage Participants and their loved ones to live independently. Committed to standing out from the rest, our home care services...
BrightStar Care of W. Montgomery Co. offers in-home care and medical staffing that goes above and beyond. We call it “A higher standard." Our Professional Care Team, led by a Registered Nurse Director of Nursing,...
At Homewatch CareGivers, we pride ourselves on being one of the oldest and most trusted providers of customized in-home care services. We know that inviting someone into your home is an important and complex decision,...
Providing Quality Care in Philadelphia Peaceful Hands Home Care is a locally owned and operated home care agency that provides quality care to seniors and adults with disabilities in the Philadelphia area. We offer a...
Home Matters of Philadelphia-- Montgomery County is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elders Choice of PA is a provider of non-medical home support services in Southampton, PA. Our company was built around the idea that, ultimately, what makes a quality life possible is our clients' sense of...
We offer a broad spectrum of services, from personal care and companionship to specialized medical and therapeutic support. By carefully matching clients with skilled, compassionate caregivers, we ensure that the services...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
We provide non-medical, aide services and companion care to seniors, elderly, and physically challenged adults. Through coordinated care and support for clients and their families, we enable our clients to live at home...
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...
Beattitudes Home Health is a trusted provider of high-quality in-home care services, dedicated to supporting individuals in maintaining their independence and quality of life.
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...
Our Services. At 5karats of love we provide... In home care Personal care Non skilled care Monitor vital signs accompany doctor appointments Warm companionship Meal preparation Light...
We Provide: Bathing and dressing assistance Preparing meals Grocery shopping Light housekeeping Scheduling appointments Organizing transportation Our companionship services include, but are not limited...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
HomeWell Care Services of Norristown, PA is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Anastasia Care Services, LLC is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bayada Nurses is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allegiant Home Healthcare is a family owned and operated non-medical home care company. We have a combined 35 years of experience in the home and health care industry. Our experience, expertise and loyalty to the...
Montgomery Home Care is a home care provider that services in Norristown, PA. 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,...
At GROW TOGETHER HOMECARE LLC, we understand the significance of compassionate, tailored home care. With a steadfast commitment to enhancing the lives of our clients, we provide personalized support that fosters...
A Special Way Homecare is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cozy At Home, LLC is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Attentive Caregivers LLC is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our founder Quiera Dover watched many patients, seniors, and clients with intellectual disabilities fight to gain independence and decline in their ability to do for themselves. Quiera found that most seniors want to be...
For more than 10 years, Senior Helpers has been providing customized professional care services to seniors and families throughout the Pottstown area. To support aging in place, we provide a full variety of services...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
At Amada Chester County, we strive to provide the highest quality of care with a sense of warmth, kindness and compassion. Each member of our team is committed to your loved one because to us, they are family. We take...
We offer compassionate, personalized home care and mental health coaching tailored to the unique needs of each individual. From senior care to support for children with Autism or ADHD, we create a nurturing environment...
A Ray of Sunshine is a Private Home Care Agency. We designed a well-rounded program that encourage Participants and their loved ones to live independently. Committed to standing out from the rest, our home care services...
BrightStar Care of W. Montgomery Co. offers in-home care and medical staffing that goes above and beyond. We call it “A higher standard." Our Professional Care Team, led by a Registered Nurse Director of Nursing,...
At Homewatch CareGivers, we pride ourselves on being one of the oldest and most trusted providers of customized in-home care services. We know that inviting someone into your home is an important and complex decision,...
Providing Quality Care in Philadelphia Peaceful Hands Home Care is a locally owned and operated home care agency that provides quality care to seniors and adults with disabilities in the Philadelphia area. We offer a...
Home Matters of Philadelphia-- Montgomery County is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elders Choice of PA is a provider of non-medical home support services in Southampton, PA. Our company was built around the idea that, ultimately, what makes a quality life possible is our clients' sense of...
We offer a broad spectrum of services, from personal care and companionship to specialized medical and therapeutic support. By carefully matching clients with skilled, compassionate caregivers, we ensure that the services...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
We provide non-medical, aide services and companion care to seniors, elderly, and physically challenged adults. Through coordinated care and support for clients and their families, we enable our clients to live at home...
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...
Beattitudes Home Health is a trusted provider of high-quality in-home care services, dedicated to supporting individuals in maintaining their independence and quality of life.
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...
Our Services. At 5karats of love we provide... In home care Personal care Non skilled care Monitor vital signs accompany doctor appointments Warm companionship Meal preparation Light...
We Provide: Bathing and dressing assistance Preparing meals Grocery shopping Light housekeeping Scheduling appointments Organizing transportation Our companionship services include, but are not limited...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
HomeWell Care Services of Norristown, PA is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Anastasia Care Services, LLC is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bayada Nurses is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allegiant Home Healthcare is a family owned and operated non-medical home care company. We have a combined 35 years of experience in the home and health care industry. Our experience, expertise and loyalty to the...
Montgomery Home Care is a home care provider that services in Norristown, PA. 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,...
At GROW TOGETHER HOMECARE LLC, we understand the significance of compassionate, tailored home care. With a steadfast commitment to enhancing the lives of our clients, we provide personalized support that fosters...
A Special Way Homecare is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cozy At Home, LLC is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Attentive Caregivers LLC is a home care provider that services in Norristown, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our founder Quiera Dover watched many patients, seniors, and clients with intellectual disabilities fight to gain independence and decline in their ability to do for themselves. Quiera found that most seniors want to be...
For more than 10 years, Senior Helpers has been providing customized professional care services to seniors and families throughout the Pottstown area. To support aging in place, we provide a full variety of services...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
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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.