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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.*
✔
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 Helpers Montclair was established by Ghada Lutfi in 2009. Ghada and the Montclair office pride themselves on providing experienced, compassionate and personalized in-home care services to families in the San...
Gentle Care Service LLC is a compassionate home health care agency dedicated to enhancing the well-being and independence of seniors and individuals in need. We provide personalized services, including companion care,...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
Founded in 2020 by industry veterans. After 16 years of combined home care nursing experience across different aspects of the home care field, Prestige Home Care Angels' founders decided to start their own home care...
Since 2020, Cornerstone Caregiving has enhanced the lives of tens of thousands of seniors across the United States. We believe seniors deserve the choice to age when and where they want. As a leading nationwide home care...
Chizo and Nikky Abanobi, owners of Amada Senior Care Pomona, view their role as part of a larger commitment to our population of cherished seniors in Diamond Bar, Montclair, Pomona, Rowland Heights, Walnut, West Covina,...
Calvary Senior Care LLC is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homewatch CareGivers of Yorba Linda, CA is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Instead enables the elderly to live independently. It’s at home where quality of life is enhanced without the stress of interrupted routines and changes in daily habits. Our non-medical CAREGivers provide...
PremiumCare is a leading in-home care agency serving clients in Riverside County. Our team of dedicated and highly trained companion home care staff specializes in providing compassionate and professional assistance to...
Homewatch CareGivers of Glendora is committed to delivering compassionate, personalized care solutions that honor each client's unique preferences and needs. Our team of skilled caregivers, driven by a dedication to...
Goodcare Home Health Mgmt is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AMAZING SUPPORT HOME CARE LLC is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Asap Home Health Providers, Inc is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
La Homecare Provider Inc is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
St Mary Home Health is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interlink Health Care, Inc is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ease of Mind Hospice is a home care provider serving Tarzana, CA 91356. Our services enable seniors to stay safely in their own homes while receiving medical care or assistance with personal tasks. We offer a range of...
Senior Helpers Montclair was established by Ghada Lutfi in 2009. Ghada and the Montclair office pride themselves on providing experienced, compassionate and personalized in-home care services to families in the San...
Gentle Care Service LLC is a compassionate home health care agency dedicated to enhancing the well-being and independence of seniors and individuals in need. We provide personalized services, including companion care,...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
Founded in 2020 by industry veterans. After 16 years of combined home care nursing experience across different aspects of the home care field, Prestige Home Care Angels' founders decided to start their own home care...
Since 2020, Cornerstone Caregiving has enhanced the lives of tens of thousands of seniors across the United States. We believe seniors deserve the choice to age when and where they want. As a leading nationwide home care...
Chizo and Nikky Abanobi, owners of Amada Senior Care Pomona, view their role as part of a larger commitment to our population of cherished seniors in Diamond Bar, Montclair, Pomona, Rowland Heights, Walnut, West Covina,...
Calvary Senior Care LLC is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homewatch CareGivers of Yorba Linda, CA is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Instead enables the elderly to live independently. It’s at home where quality of life is enhanced without the stress of interrupted routines and changes in daily habits. Our non-medical CAREGivers provide...
PremiumCare is a leading in-home care agency serving clients in Riverside County. Our team of dedicated and highly trained companion home care staff specializes in providing compassionate and professional assistance to...
Homewatch CareGivers of Glendora is committed to delivering compassionate, personalized care solutions that honor each client's unique preferences and needs. Our team of skilled caregivers, driven by a dedication to...
Goodcare Home Health Mgmt is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AMAZING SUPPORT HOME CARE LLC is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Asap Home Health Providers, Inc is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
La Homecare Provider Inc is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
St Mary Home Health is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interlink Health Care, Inc is a home care provider that services in Pomona, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ease of Mind Hospice is a home care provider serving Tarzana, CA 91356. Our services enable seniors to stay safely in their own homes while receiving medical care or assistance with personal tasks. We offer a range of...
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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.