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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.
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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:
At VIP Home Care Services, we understand that entrusting someone with your loved one’s care is a big decision. Our mission is to provide professional, compassionate care while ensuring warmth, comfort, and companionship....
ComForCare Home Care in San Fernando Valley is a premier provider of non-medical, private duty home care services. We assist people with the activities of daily living in any setting, whether it be a private residence,...
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...
At Senior Helpers of North Valley, we are committed to providing personalized, compassionate care that meets the needs of both seniors and their families. We believe that everyone deserves to age with dignity, purpose,...
WelbeHealth is a Program of All-Inclusive Care for the Elderly (PACE), full-service healthcare provider that helps you live your life healthy and happy, in your own home.
Perfect Fit Home Care is a home care provider that services in Toluca Lake, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aging, disability, illness or injury can make living at home a challenge. We believe that no one should have to face the long list of complex decisions and unforeseen changes alone. We are experts, providing not just...
We own quality care. Invested in-home care for your loved one You want a dedicated caregiver for your loved one. Keeping your loved one at home is important. But, finding a caregiver who listens to your needs and...
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...
Backed by over 25 years of industry experience, our team at VIP Home Care has delivered quality elder care, supporting thousands of clients throughout the region.
The Amada Senior Care team in San Fernando Valley is dedicated to going beyond basic home-care by gaining a deep understanding of clients and their individual needs so that they can make a truly positive impact on their...
We believe in creating a supportive environment where your well-being flourishes, ensuring every interaction is marked by empathy, expertise, and a commitment to enhancing your quality of life.
Our mission is to help seniors maintain their independence and quality of life by offering compassionate, professional home care services. We specialize in a wide range of services that allow individuals to remain in the...
The main goal of Calming Palm's Home Care LLC is to provide services that prioritize comfortability, least-restrictive setting, and a piece of mind. We want to make a significant difference in your life by being there for...
We specialize in providing value-based, comprehensive care and coverage for older adults with significant needs so they can thrive in the homes they love and in the communities they cherish. Our high-touch, team-based...
Recently Awarded The Top 100 Leader in Experience with the highest Overall Satisfaction (OSAT) scores. We are #1 in Fresno and Kern Counties, and #2 Across the United States.
You want to live in your own home for as long as possible. Assisted Healthcare Services’ caregiver services enable seniors to age-in-place and embrace their independence.
Welcome to Minoru Home Care, Inc. 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...
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...
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 Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations as...
We provide professional, affordable, and caring in-home living assistance for seniors in the Ventura County and Los Angeles County area. We are committed to providing high quality, client-centered and affordable Home Care...
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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.