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.
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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:
Senior Serenity Home Care, is not only our name, but it stands as our way of service. We bring safe, loving, and caring services to those that desire to have a nursing home setting and treatment, in the comfort of their...
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...
Our Mission is to provide our clients with options, promote independence, embrace quality of life but more importantly provide a safe space for our seniors, veterans and people with disabilities to participate. With our...
HomeWell is committed to helping people live life more fully. With a highly personalized care management approach, we strive to provide the highest quality of care in the place where clients feel most comfortable.
Greenwich HomeCare is a locally owned and operated non-medical home health care agency dedicated to providing the highest quality home health aides. We are a licensed, bonded, and insured agency serving Greenwich,...
Anchored Care LLC is a compassionate home care service dedicated to providing personalized, high-quality care for seniors in the comfort of their own homes. Our trained caregivers offer assistance with daily activities,...
Our 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 compassionate care in the...
Our vision is simple: we aim to be the leading provider of home care services. By providing personalized, compassionate support, we help our clients live with dignity and peace of mind. Reach out to us today to discuss...
The Cassagnol Agency, based in Connecticut, provides home health care, senior care, and financial planning services. They assist with daily activities like bathing, dressing, meal prep, and medical appointments, alongside...
At Absolute Best Home Care, our vision is to be a meaningful contributor to the communities we serve making a lasting impact in the lives of the seniors and giving back to the community.
It doesn’t matter if you’re here because you’re looking for help living independently, or if you want to make sure someone you love has the support they need to stay in their home. We believe there’s more to caring for...
The most qualified professionals in the health and wellness community. Our mission is to provide the most qualified, experienced and compassionate nurses and specialists to healthcare institutions, hospices, government...
Caring for your loved ones can be challenging, especially if they have special needs, illnesses, or injuries. Fortunately, Homewatch CareGivers of Norwalk is here to help you provide the best care and support to your...
There’s a reason why Unity Home Care LLC, is a leading provider of homecare in Farmington, Connecticut, and that’s simply because we truly care for you! Elderly, injured, ill, and the disabled—we make every high-quality...
Efficient Aids Agency is a trusted Homemaker Companion Agency committed to providing compassionate and professional care to individuals who need assistance in their daily lives. Our experienced team offers a range of...
With Nissi Agency you can entrust your loved ones to our experienced management and dedicated staff, who will go above and beyond to ensure that your loved one receive the best care.
There is no greater responsibility than entrusting someone with the care of a loved one. I know this firsthand because I lived it with my own family. It is my personal journey that led me to pursue a career with Senior...
Based in Waterbury, Connecticut, we specialize in providing personalized home care services designed to meet the unique needs of each individual. From compassionate personal care and fall prevention to friendly...
Assuring Alliance Caregivers LLC is a trusted home care provider in Connecticut, dedicated to delivering compassionate and personalized support for seniors and individuals in need. Our skilled caregivers offer services...
BrightStar Care of Fairfield, CT is a home care provider that services in Norwalk, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our caregivers can provide personal care, homemaking services, and companion care. These services include bathing, dressing, continence care, meal planning/preparation, cleaning, laundry, and running errands.
Bayada Nurses, Inc is a home care provider that services in Norwalk, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
McKesson Health Solutions is a home care provider that services in Norwalk, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sovereign Home Health of Connecticut provides in-home care that makes a difference in the lives of seniors and other adults. Our clients and their families trust their care to us. Whether part-time companionship services...
At Caring For You Home Care, our mission is to ensure you or your loved one are able to remain at home and be cared for and assisted in the ways that you need. Our team, staff and caregivers are patient, kind and eager to...
Stellar Homecare is a home care provider that services in Norwalk, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Norwalk, CT is a home care provider that services in Norwalk, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are dedicated to providing our senior community with the highest standard of home and personal care assistance. Whether you’re seeking support for yourself, a relative, or someone in your care, we’re here to help....
Nova HomeCare is a home care provider that services in Norwalk, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring People is a family-owned and operated home care agency with more than 25,000 clients served over the past 20 years. We provide a wide range of care-based services, including Alzheimer’s and dementia care, companion...
My name is Steven and after a long career on Wall Street working at Cantor Fitzgerald, the firm that lost 658 souls on 9/11, I decided to leave the industry and build a home care business. The loss of so many friends had...
We provide home care services in Connecticut. Whether you need 24 hour live-in care or hourly care, we can meet your needs and exceed your expectations. Our aides will help your loved one with shopping, meal...
Quality Care We believe high quality care and high quality of life go hand in hand. We’re dedicated to setting the standard for private in-home care services, making sure excellent caregivers work together and put the...
Caring For Seniors is a home care provider that services in Norwalk, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CONSTELLATION IN HOME CARE Our compassionate caregivers provide excellent care and support for you in the comfort of your home. Our goal is to create a happy, secure and nurturing environment while helping you...
In Home Care for Fairfield County, CT - FirstLight Home Care of FairField County is the business to turn to when you or a family member needs help at home. Our home care services, available to Norwalk and surrounding...
Visiting Nurse & Hospice Of Fairfield County, Inc is a home care provider that services in Norwalk, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Norwalk, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
After nearly 20 years of care, HomeWell has helped tens of thousands of families with millions of hours of assistance and compassion. We provide quality in-home care for seniors across the United States and Canada. Since...
Endurance Home Care is a non-medical Home Care Agency in Connecticut. Our mission is to improve the quality and duration of life for our clients while providing enriching opportunities for our Care Professionals. We...
Giving Hearts Home Care provides assistance with activities of daily living such as bathing, dressing, meal preparation, housekeeping, laundry, med reminders, ambulation, appointment transportation, and other tasks. Our...
Castle Group Home Care and Senior Advisors provides professional, affordable, and caring in-home living assistance and advice for seniors and their families. We dedicate our lives and our services to make the lives and...
Whether due to a temporary situation such as recovering from illness, injury or hospitalization or something longer-term such as the challenges of aging or a disability, including senior, elder or respite home care,...
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...
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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.