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:
As a provider of home care services in Bloomingdale, Illinois, we are committed to providing compassionate home health care rooted in the values of doing what is right and noble. Inspired by the Hebrew word “Mishle,”...
We specialize in providing high-quality nonmedical care services for seniors, helping them maintain their independence and dignity at home. Our founder's journey as a caregiver for over 15 years has shaped our approach...
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...
For 24 years, TheKey has earned the trust of more than 120,000 clients by delivering 12 million hours of personalized home care each year using our science-backed Balanced Care Method® that actively supports well-being....
Resurrection Home Care LLC is a leading provider of in-home care services in the United States. Our mission is to provide compassionate and personalized care to seniors, individuals with disabilities, and those recovering...
Cornerstone Caregiving is proud to provide exceptional in-home care in North Chicago and its surrounding areas. We offer a wide range of services including veteran’s care, palliative care, respite care, senior care,...
Perennial Home Care Services LLC is a home care provider that services Chicago, IL 60634. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care...
Supporting independence, dignity and quality of life... That's the ComForcare vision and our promise to our clients. Since 1996 ComForcare has specialized in delivering affordable, guaranteed home care services to...
Illinois Home Health Agency LLC is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Omega Home Healthcare, Llc is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Duplicate - Home Helpers Home Care of Northeastern, IL is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or...
ActiveCare Home Care covers the entire Chicago, IL area with its home care caregiver services. A free in-home assessments is provided to help us better understand what you and your familys needs are, and then a care plan...
Agape Home Health Care, Inc is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
From Home Care to Home Health, PurposeCare walks with clients and their families through the continuum of community-based care delivering services in a coordinated manner that enhances quality, reduces cost and most...
Prime Home Health Services, Inc is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
As a pioneer in the home care industry, founded by an RN over 26 years ago, we are a highly respected provider of personalized home care services. A-Abiding CARE, Inc. in Park Ridge provides home health care services in...
Good Heart Home Care is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Prohealth Homecare, Llc is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Prime Care Resource, Inc is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Wound & Rehab Home Health Care, Inc is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Chicagoland Home Health Provider, Inc is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
1st Choice Home Health Providers, LLC is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Renaissance Home Health Servic is a home care provider that services in Park Ridge, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Helpers of Greater Chicagoland 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...
Vision & Mission At FirstLight Home Care, we envision a world in which all adults may age with comfort, dignity and independence in the place they call home. We exist to help people have their best day, every day. Our...
Compare Home Care Agency Costs & Services
×
Success!
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.