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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:
Eve HomeHealth Care provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist wi
We are strong believers in the health of our caregivers as well as our clients. Family Caregivers provide many hours of assistance to their loved ones and that can take an enormous toll. This is called burnout and can...
We strive to develop and maintain lifetime relationships with clients and families as a Private Homecare Provider, for Personal Support Services. Our services are rendered to individuals who prefer to stay and live...
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
Our philosophy at Wise Home Care is to provide the quality of care that we would want for our loved ones. Home care is a sincere appreciation of and for the people we serve. We invite you to call us to discuss how Wise...
SOLEO HOME CARE SERVICES Soleo Homecare Services of Columbus, Ohio is dedicated to providing exceptional healthcare staffing solutions tailored to meet the unique needs of homecare environments. Our mission is to deliver...
At Hopewell Horizons Home Care, our mission is to provide compassionate, personalized, and professional care that enhances the quality of life for individuals in the comfort and safety of their own homes. We are dedicated...
Ray and Lisa are owners of HomeWell Senior Care of Central Ohio. When they discovered that they could own a business that helped seniors age gracefully and with dignity, they knew this was exactly what they wanted to do!...
Comprehensive Care Solutions by Gihon Care At Gihon Care, we’re dedicated to providing personalized care that meets the unique needs of every individual. Our services support clients in maintaining independence and...
The Compassionate Team At On Demand Companion Provides Essential In-Home Support To Seniors Who Cannot Care For Themselves. Our Caregivers Are Committed To Delivering Heartfelt Home Care Services, Offering Non-Medical...
Compassionate Senior Home Care Be assured your loved ones will receive quality senior home care from our professional caregivers. Safety and quality come first: our experienced senior caregivers undergo rigorous...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home somewhere in Buckeye Nation. We service all of Columbus and its surrounding areas, including Marysville...
Advanced Senior Support Home Health is a home care provider that services in Westerville, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Registered Nurses Care Ltd is a home care provider that services in Westerville, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tri-City Homecare, Inc is a home care provider that services in Westerville, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to provide individualized and compassionate care to those in need of short-term and long-term assistance due to surgery, illness, or aging. We strive to enhance their quality of life by empowering them to...
At Homewatch CareGivers, we understand how important it is to provide the utmost quality care for your loved ones. When thinking about the care we provide, we often ask ourselves, “Is this the kind of care we’d want to be...
AMOUREUX HEALTH LLC is a home care provider that services in Westerville, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Andab Care LLC, we help seniors and older adults with non-medical activities of daily living including meal preparation, assistance with bathing, dressing, toileting, light housekeeping, medication reminders,...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Excel Health Services is a home care provider that services in Westerville, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Experience personalized elderly care with Visiting Angels. Choose your caregiver, maintain your schedule, and receive tailored services. We prioritize your comfort and independence. You're in charge of your schedule -...
1st Century Home Health Services in Ohio provides comprehensive home health care services tailored to meet the individual needs of patients in the comfort of their own homes.
Nursing Support Care, LLC is a home care provider that services in Westerville, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home has a 10 year presence serving the Senior Citizen community. Right at Home offers caregiving services for almost any family and practically any situation. Our in-home care lets loved ones enjoy healthy lives...
Ash Brothers Home Health Care is a home care provider that services in Westerville, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Amada we understand that caring for relatives can be rewarding but also stressful, time consuming and emotionally exhausting. It is difficult for families to juggle work, children and other obligations and still find...
Agape Health Care Agency, Llc is a home care provider that services in Westerville, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mount Carmel Home Care is a home care provider that services in Westerville, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kean Dillon opened the Senior Helpers Columbus office to provide high quality in-home senior care in the community of Westerville and surrounding areas. Senior Helpers strives to treat clients with the same warmth,...
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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.