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:
Golden Touch Homecare LLC is a home care service provider dedicated to offering high-quality, compassionate, and personalized care to individuals who need assistance with daily living activities. The company specializes...
Home Instead - Renton, WA is a home care provider that services in Renton, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Helpers is the premier provider of senior care, wherever your senior resides. We provide in-home care and personalized care in the comfort of your own home and at other residential locations including assisted...
At SHINING Home HealthCare LLC, we strive to provide professional, holistic, caring, compassionate and curative services to our clients, assisting them achieve maximum rehabilitation in the comfort of their own home.
Agency Description Eronia Care LLC, Compassionate In-Home Care Services At Eronia Care LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
Homewatch CareGivers of Mountlake, WA is a home care provider that services in Renton, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hubaal Home Care is a licensed provider of Home Care in Seattle, Washington approved by the Department of Health in March 2019. We are strategically located in Washington to serve the people with disabilities and ailments...
At Golden Hour Home Care, we are committed to providing compassionate, personalized care for individuals in the comfort and familiarity of their own homes. Whether you or your loved one need assistance with daily...
At Revere Home Care, we're committed to delivering dependable, high quality home care with integrity. We believe in treating our clients like family and that means following through to make it right.
At Northwest Home Care Services LLC our mission is to provide compassionate and personalized home care services to our clients. We strive to improve the quality of life for those we serve, while prioritizing their safety...
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...
At Masta Logic Compassionate Care LLC, we are dedicated to enhancing the quality of life for seniors through our expert in-home care services and nursing pool.
iding Quality Senior Care Wherever You Call Home in Tukwila, WA and the Surrounding Area We provide care in the home, wherever that may be. Whether you and your family need a short term companionship option or more in...
Best Choice Home LLc is a home care provider that services in Renton, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With Hyatt Home Care as your home care services provider, you will enjoy personalized service built around your needs. We know you have a lot of questions about home care services for your elderly loved one. We have a...
At Plentiful Care, LLC, our mission is to provide exceptional and personalized home care services to our clients. We strive to promote independence, improve the quality of life, and enhance the overall well-being of our...
Our vision at Homecare Partners is to become the preferred home care provider in the state of Washington, known for excellence and dedication to each client served. Our commitment is to care for our client at their most...
Our client’s health and well-being are our priority. We pride ourselves on providing aid for aging adults while maintaining their freedom and finding joy in everyday situations. Our compassionate care services prioritize...
Providence Home Services - King County is a home care provider that services in Renton, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We Are Available For Home Care Consultation At New Life Home Care, we believe that seniors deserve to live with dignity, respect, and joy. We are here to make that possible by providing reliable, compassionate care...
There is no place like home. Northwest Guided Home Care makes aging in place possible for millions of seniors. Moving out of your home into a nursing home or an unfamiliar place can be traumatizing for most seniors....
Grandcare is a home care provider that services in Renton, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AccentCare of Washington, Inc. is a home care provider that services in Renton, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Serengeti Care - Westside is a home care provider that services in Renton, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Care with Compassion LLC, we are dedicated to providing high-quality, personalized home care services that prioritize the dignity, independence, and well-being of our clients. Our compassionate caregivers deliver...
Kindness Adult Family Home is a home care provider that services in Renton, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring for seniors is a labor of love and requires a special person. At Salama Care we specialize our services to fit your needs, whether it be a few hours or around-the-clock care, we work with you to ensure we meet...
Our Focus Is Helping Seniors Live Well At Home. At CarePro Northwest, we believe in creating special moments for our clients each and every day, whether at the bedside, on the phone or in the clinic. These moments...
B’Zoe Home Caregiving Services was founded by Prossie Lockett, who immigrated to the United States from Uganda. Although she worked in the embassy, she opted to leave her home due to many reasons, including genocide, in a...
SeaCare In-Home Care Services SeaCare was born out of the need to do better for our loved ones and our community. The founder of SeaCare witnessed her grandmother receiving subpar care, and she knew the only way to make...
Griswold Home Care is a non-medical home care company. We refer Caregivers who provide in-home care services including personal care, homemaking, companionship, and other home care services. Griswold Home Care was...
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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.