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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.*
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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:
APEX Health Services comprises a team of experts who redefine the continuum of health care model for optimal patient outcomes. We are committed to innovative care models that provide a full spectrum of services evolving...
We’re here to help you continue living independently. If you or a loved one is having trouble with activities of daily living, home safety or personal care, we can provide a specialized program to make life easier and...
We are licensed by the Illinois Department of Public Health as a Home Services Agency and our company and our employees are licensed, bonded and insured. We are a proud member of the Home Care Association of America....
Homewatch CareGivers' servicing Orland Park, Oak Park, Oak Lawn, and South West of Chicago is committed to being the premier provider of home care in the Chicago area. Our outstanding and dedicated office staff and...
We are a dedicated homecare services provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity.
Home & Hearth Caregivers is available 24/7 for you or your loved one. We serve Cook, DuPage, Kane, Kendall, Lake, McHenry and Will counties. Our experienced Care Plan Managers will be happy to provide a complimentary home...
Greg Farley and Rob Storey, owners of Amada Senior Care Orland Park, understand from personal experience the tremendous difference that quality senior care provided with compassion and competence can make in the lives of...
Recognized For Our Devotion To Clients and Caregivers Our goal is not to be the biggest home care company, it's to be the best home care company. The most accurate way to measure that standard is comparing ourselves to...
Harvest In-HomeCare Inc. - Plainfield, IL is a home care provider that services in Orland Park, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In-home care services can help people at any point within the aging process. We’ll work with you to develop a personalized care plan tailored to help fit your family’s needs. Our expert care provides all the support...
Gbs Memorial Home Health Services is a home care provider that services in Orland Park, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Helpers - Orland Park, IL is a home care provider that services in Orland Park, IL. 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,...
SYNERGY HomeCare of Orland Park, IL is a home care provider that services in Orland Park, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Distinct Home Health Care, Llc is a home care provider that services in Orland Park, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Have A Heart Health Care, Ltd is a home care provider that services in Orland Park, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Steadfast Home Care Health Services, Inc is a home care provider that services in Orland Park, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Destiny Senior Care - Orland Park, IL is a home care provider that services in Orland Park, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Atnt Home Care, Inc is a home care provider that services in Orland Park, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Angels Home Health Services, Inc is a home care provider that services in Orland Park, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Why Choose TAF Shalom? We provide In-Home Nursing and Homemaker services that are tailored to meet individual needs. We provide a level of service that meets and exceeds the healthcare industry's standards We...
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...
Looking for quality home care services? Look no further! Senior Helpers of Bolingbrook offers 1 hour to 24/7 live-in care with no minimum hours and competitive rates. Our senior care services include same-day intakes,...
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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.