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:
From delivering specialized home care to managing everyday tasks, or simply keeping your loved one company, we’ll work with you to develop a custom home care plan that compassionately responds to your loved one’s needs,...
With highly personalized care and a dedicated team of compassionate caregivers, you and your family can expect more from HomeWell Care Services in Lawrenceville, Gwinnett County and surrounding areas.
North Georgia’s premier home health company, where we specialize in personalized care solutions for individuals in need. Our dedicated team views themselves as an extended support system for clients and their families,...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Our Mission is to give quality care. We have our Nurses and Personal Care Assistants matched for compatibility. Companionship is key to a trusted relationship with our caregivers. With our home health care services, we...
At Chapman & Friends Healthcare Providers of Georgia, we believe that every individual deserves compassionate and personalized care that is tailored to their unique needs. Our mission is to provide exceptional in-home...
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
At Senior Helpers of Lawrenceville, we know how challenging it can be to get the help you or your loved one needs. We have been in the exact same spot as you are in now. Our owners, Debbie and Julio, opened their...
Senior Solutions is a non-medical comprehensive home care agency that trains caregivers who assist our clients with activities of daily living in their own homes. In recent years, we have also added service lines to help...
Jojo Home Care Services, Compassionate In-Home Care Services At Jojo Home Care Services, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence....
Hearts of Love Caregivers helps families with non-medical in home care. We offer in home health care in select locations. With Hearts of Love Caregivers, every client receives extra ordinary care from our caring team. We...
Charlotte Web Private Home Care, LLC is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Sahara Georgia Home Care LLC offers compassionate, personalized home care services to individuals in Georgia, ensuring comfort and support in their own homes with a focus on enhancing the quality of life for both patients...
Our in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing compassionate care in the...
Serenity Care and Compassion is Locally Operated, Licensed, Bonded, Insured, and have been providing compassionate care in Georgia For 15+ Years and are happy to provide services to older adults and children in need of...
Premium Nursing Services, Inc is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
We understand that receiving care at home is a personal decision. At Harmony Angels, we’re dedicated to providing compassionate and high-quality care that allows you or your loved one to live life to the fullest, in the...
Hope Private In Home Care is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ALTERNATIVE HOME CARE FOR SENIORS, INC is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
LEAN ON ME HEALTH CARE AGENCY is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home—there’s no place like it. It’s where your memories are. Where you raised your family and where friends have gathered for life’s celebrations. It’s been your basecamp through good times and bad. And it’s where you...
A PASSION FOR PEOPLE HOMECARE LLC is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premium Nursing Services would like the opportunity to provide care and service to your medical nurse needs. Our professionals will devise a plan of care aimed at promoting independence, no matter what your specific needs...
Emerald Healthcare Services, Inc. is a Georgia state licensed private homecare provider.We have professional and licensed RNs, LPNs and CNAs who will work with your physician to create a plan of treatment and achieve the...
Sista’s Compassionate Care Services (SCCS) was founded on the notion of compassion and proper care. The founder’s, Merlyn Bastien and Guerline Benjamin, have a combined 15 years of experience in the senior care field. We...
At Love Thy Neighbor Home Care, we understand how important it is to receive high-quality service in the comfort of your home. If you are looking for an agency that will provide comprehensive and affordable home health...
Janet McLaren, owner of Amada Senior Care Snellville, views her role as part of a larger commitment to our population of cherished seniors in Greater Snellville and surrounding areas. To Janet, elders create the...
UNITY CARE HOME LLC is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CAMBRIDGE CARE LLC is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tender Care Health Services is a private home care provider, licensed by the Georgia Department of Community Health, to offer personal care and companion/sitter services.
At Mercy Home Care Services our certified trained home health aides will provide support with activities of daily living. We carefully select the best home senior caregivers to ensure your comfort, convenience, health and...
Infinity Homecare Service is a one of a kind home care program. Atlanta Homecare Specialist, Sharon, set out in 2010 to provide a top-notch home care service company with superior care and attention to details. Grounded...
Our Mission At Abena Health Solutions, our mission is to redefine home health care by providing a personalized and intimate approach that truly makes a difference in the lives of our clients. We take immense pride in our...
Providing the Best care with Southern Charm and Hospitality When we take care of your family they become our extended family. We hire the Best Caregivers!!! We are here to take your worries away! We provide...
With the help of CareMinders® Home Care, you or your loved one can receive needed care and assistance while also being able to enjoy the comfort and stability of home. Our highly trained and certified staff will work...
AZA HEALTHCARE SERVICES LLC is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Affordable Nursing and Sitter Service, our mission is to provide compassionate and reliable home care services to our clients. We strive to improve their quality of life and help them maintain independence in the...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
Our Mission: To provide exceptional home care services that empower individuals to maintain their independence, health, and well-being in the comfort of their own homes. Our Purpose: At MNR Home Care Services, we...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Premium Nursing Services Inc. is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Vicinity, LLC is a home care provider that services in Snellville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
PathMedic is a home health care services provider. Our National Provider Network Referral Services Organization offers the highest level of expertise with intense focus on quality, and the commitment to client services....
At Gad Health Care, our mission is to provide professional and paraprofessional services to clients in their homes and assisting them to achieve the highest level of potential in their day-to-day self-care activities. We...
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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.