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:
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Center For Elders’ Independence PACE (Program of All Inclusive Care for the Elderly) provides high-quality, affordable, integrated healthcare services to vulnerable seniors promoting autonomy, quality of life, and the...
Live Well At Home By Eskaton-Danville-CA is a home care provider that services in San Ramon, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
FirstLight Home Care of Tri Valley, CA (305A) is a home care provider that services in San Ramon, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Being the family caregiver can prove to be a challenge. You may feel burnt out or just overwhelmed trying to manage your own life, while helping your loved one. If you are supporting someone through a medical crisis or...
Thrive Home Care - San Leandro is a home care provider that services in San Ramon, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
Arcadia Home Care - Campbell, CA is a home care provider that services in San Ramon, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
Senior Helpers Contra Costa 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...
Everyone needs a helping hand. We're here to bring you better quality of life through convenient, compassionate, and consistent service: whenever and wherever you need us. Peace of mind. Quality of life. That's what...
ComfortKeep Home is a professional and compassionate home care service provider dedicated to improving the quality of life for seniors, individuals with disabilities, and those recovering from illnesses or surgeries.
We understand the journey of aging can be rewarding but also challenging, both physically and emotionally. ACASA Senior Care East Bay provides non-medical, in-home care solutions throughout Walnut Creek, San Ramon,...
We at FirstLight Home Care exist to help people have their best day, every day. Our mission is to provide compassionate home care so that the families we serve have peace of mind knowing their loved ones are receiving the...
At Homewatch CareGivers of Pleasanton, we're not just another in-home care company. We're a lifeline for families and individuals needing compassionate, personalized care. Our services cater to a diverse range of needs,...
ARE YOU LOOKING FOR RELIABLE, QUALITY CAREGIVERS? THEN Home Helpers is the answer. You get peace of mind because: Our home helpers show up on time; Our home helpers are courteous and friendly; Our home helpers pay...
Green Pastures Home Care LLC is a home care provider that services in San Ramon, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Maplewood Home Care is a trusted provider of high-quality in-home care services dedicated to supporting individuals in maintaining their independence, comfort, and dignity. With a compassionate team of skilled caregivers,...
Lorvin Home Care is a home care provider that services in San Ramon, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alliance Home Health Care is a home care provider that services in San Ramon, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With the changes in the healthcare industry, more and more people are expected to recover within their homes despite the lack of resources and education. As founders who possess years of experience in Emergency Nursing,...
Elegant Care at Home is dedicated to providing high quality, compassionate and supportive services in an ethical manner. We are a member of Companion Connection Senior Care, a national membership organization of...
Reli-ance Home Care Llc is a home care provider that services in San Ramon, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to help you maintain a high quality of life through best health practices, and our entire staff is dedicated to this goal. We offer holistic solutions to meet all of your health needs.
Accentcare Home Health of California, Inc is a home care provider that services in San Ramon, CA. 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,...
We care for patients of all ages in different settings, be it at home, in a hospice facility, in a nursing home, or some other care facility. We believe that everyone should have access to quality care.
There is an incredible demand in our society for care professionals, and we are proud to be up to the task. And it's not just for seniors — if a member of your family needs help, we're the place to call. As we are a...
Helping People in the Tri-Valley and Neighboring Areas in the East Bay Whether you’re a senior, recovering from surgery, a busy new mother, or just need an extra hand around the house with daily activities, you can...
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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.