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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.
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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:
ComForCare provides customized in-home care plans tailored to each client’s needs. Through in-home evaluations and interviews with clients and their families, we create a personalized care strategy that ensures the...
Love Thy Neighbor Senior Care is a licensed home health agency that is passionate about elderly care. Our team is committed to providing superior service and client satisfaction.
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...
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...
Harmony Care Home Care Agency is a compassionate and reliable provider of in-home care services designed to support individuals who wish to maintain their independence and quality of life in the comfort of their own homes.
Everyone who desires should have the opportunity to live independently. At Sunlight Senior Care, we are helping individuals live safely in their homes and maintain their independence, while often giving family members...
Executive Home Care of Omaha is dedicated to delivering compassionate one-on-one personal care services that allow seniors to remain safely and independently in the comfort of their own home or at a facility. We can...
Genuine Global Care is an in-home care agency serving Lincoln, NE, Dallas, TX, and Louisville, KY, providing personalized care to the elderly, disabled, and anyone in need of assistance, regardless of age. We specialize...
In-Home Companionship and Care Services Services Conversation and Companionship Services Meal Preparation and Grocery Shopping Services Laundry and Light Housekeeping Services Transportation Services Medication...
At Gallery Home Care, we are dedicated to providing compassionate and personalized care. Our mission is to create a safe and supportive environment where you or your loved one thrives by ensuring that every interaction is...
Our compassionate team of caregivers, nurses, and support staff are committed to providing the highest level of care. Each member of our staff is carefully selected for their skills, experience, and dedication to...
We are committed to serving our clients and anticipating their needs. We are committed to earning trust, and following through with our commitments, no matter how big or small.
BrightStar Care offers a wide variety of high-quality services—from in-home care to medical staffing. If you are looking for a trustworthy care provider or staffing partner in the Omaha, NE area, please contact us. We’re...
Herewith, Inc. is a nationwide platform connecting families in Nebraska with experienced, background-checked caregivers for non-medical in-home care. Their services include assistance with light housekeeping,...
XtraKare: Envisioning Holistic Excellence in Home Care and Staffing Services" We provide personalized home care with diversity, innovation, and community partnership.
St. Joseph Villa Homecare & Hospice is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Midwest Home Health, Inc is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The Good Care LLC is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Prime Home Care - NE is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Physicians Choice Home Health Care is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Willingham Health Services Home Care, Llc is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nurse Providers, Inc is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Zutan Home Healthcare Incorporated is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Owner Mandi Matlock knows how important it is to have an in-home senior care service that feels like family. Senior Helpers Omaha Metro understands the needs of your aging loved one and develops a custom care plan to meet...
Interim Health Care Of Omaha is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Symphony of Care We are a local service dedicated to connecting your senior loved ones with the non-medical in-home caregiving services they need to thrive. We understand that independence is of vital...
FirstLight HomeCare provides quality, affordable, non-medical in-home care for seniors, mothers just home from the hospital, those recovering from surgery and other clients with need for companionship or personal care. We...
TheKey Corporate - Omaha, NE is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Primary Home Health Care, Inc is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
Carebuilders At Home's Personal Assistant Services provide task specific services, with no minimum hours requirement, providing a cost effective alternative to traditional hourly home care and allowing our clients the...
Empowering individuals and families with compassion, integrity, and expertise, Sacred Heart Agency, LLC is dedicated to providing exceptional care and support services in Omaha, NE. Committed to upholding the values of...
Caring for People Services provides in-home, non-medical services for people of all ages. We are dedicated to helping our clients lead dignified, independent lifestyles in the comfort and safety of their own homes. We...
Aseracare Home Health is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amakes Quality Home Care Inc is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Infuscience is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Community Home Health, LLC is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Place At Home owners Rick and Kris Perkins have spent the entirety of their professional careers in public service, helping those in need. Rick is a former counselor who spent 20 years with Child and Adult Protective...
Vitalcare Home Health is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alegent Health At Home is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentiva Health Services is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amazing Angels Home Health & Hospice LLC is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Midwest Home Health, Inc Dba Angels Care Home Heal is a home care provider that services in Omaha, NE. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Home Care Assistance of Omaha, we strive to provide the highest quality care to our clients. Our Care Managers are degreed professionals, who create a comprehensive and personalized plan of care for each client, after...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
At Happy Moments Home Healthcare we provide you with high-quality care!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...
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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.