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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:
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Built with love in San Francisco, New York and Miami, by a team that has experienced the pain of finding and managing care ourselves, we’re committed to delivering better health outcomes for seniors, and peace of mind to...
Home Instead can help with compassionate, home senior care services delivered right in your loved one's home. Whether a few hours a day or long-term care 24 hours a day, a CAREGiver can assist you. All CAREGivers are...
Senior Helpers of Redwood City was founded in 2007 and purchased by Nicholas Magnusson in 2014. He became passionate about working with Seniors through his experience working as a Administrative Director at UCSF Medical...
Entrusting your health and well-being to people you personally don’t know can be challenging. You need to ensure that they are capable of doing their job and meeting all of your expectations. At Samaria Elderly Care,...
At Gentiva Personal Care, our Personal Home Care Assistance can assist with personal care, daily living necessities, and help around the home. If you or a loved one is struggling with prolonged illness, recovery from...
Arcadia Home Care - Campbell, CA is a home care provider that services in San Mateo, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Indeed provides non-medical home care services to seniors: personal care, support with mobility, help with household chores, companionship, and transportation. We also send our trained and experienced caregivers,...
At Always Best Care, we believe it’s a good feeling to be included in our clients' lives. Subtle smiles and long talks, showing kindness and humor during difficult times, providing the right levels of care – these are the...
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We know how significant it is for the seniors to receive the right amount of attention. Therefore, our caregivers dedicate their time, energy, and compassion and make their everyday lives better.
Home care is a service that you can rely on when you need assistance in the comfort of your home. If you are struggling with old age, injury, or illness, this might be the right time for you to look for a caregiver who...
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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...
SYNERGY HomeCare of San Mateo, CA is a home care provider that services in San Mateo, CA. 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...
6EMS LLC is a home care provider that services in San Mateo, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alegre Home Care is a home care provider that services in San Mateo, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
You deserve to have the optimum level of health and comfort. Whenever life’s difficulties hinder you from achieving wellness, then we are here to provide you with home care services that are specifically structured to...
Magis Care is dedicated to excellence in homecare. We have experienced care professionals who deliver trusted and reliable home care services. We provide a wide range of services from companion care, transportation,...
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Addus is proud to be a nationally recognized provider of high quality, in-home care services with over 30 years experience. Our breadth of services include Contractual Home Care, Personal Care, Homemaker, Respite, Care...
Aging and living at home is more comfortable and desirable than living anyplace else. At NuevaCare we provide responsive and quality in-home care to those who need help due to old age or recovering from surgery or illness.
Accentcare Home Health of the Bay Area, Inc is a home care provider that services in San Mateo, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Nurse Next Door San Mateo, CA is proudly making lives better in the communities of San Mateo, Redwood City, Bay View, South San Francisco, Marin, Petaluma, Vacaville and Roseville, CA providing 24 hour senior care...
Sutter Visiting Nurse Association is a home care provider that services in San Mateo, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Honor is a comprehensive home-care solution that helps older adults continue to live in their own homes with joy, comfort and grace. Honor offers the highest quality care by combining the best care professionals with...
Geriatric Home Care Specialists has been providing quality, personalized in-home care since 1994. Our journey began with the opening of our first branch in Los Gatos and has since grown to a total of four locations...
Care Indeed - San Mateo is a home care provider that services in San Mateo, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Stanford Senior Care, where compassionate care meets the comfort of home. We are dedicated to providing exceptional homecare services that enhance independence and well-being. Whether it’s assistance with daily...
Assisting Hands exemplifies compassion, dependability and dignity to all of our clients. Our company was founded on the principles of caring for others in a way that we would also want to be cared for which is made...
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It’s human nature to want to be independent and self-sufficient, but there are times in our lives when we need a helping hand. Are you a new parent and feeling overwhelmed? Are you recovering from an especially...
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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.