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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:
Exceptional Home Healthcare and Long-Term Care Insurance Advocacy. Welcome to Amada Senior Care of North Central New Jersey (Westfield / Morristown) the premier home healthcare provider headquartered in Cranford, NJ....
When we started LifeWorx in 2004, we wanted to build more than caring, empathetic care services. We wanted to build a community of giving. A place you join as an individual, ‘me’, but where you become part of a greater...
Home Matters Caregiving is compassionate care you can depend on. Discover the benefits of professional caregiving in the comfort of your home. Learn how a Professional Caregiver can help create great days for your...
Serving NJ Counties: Somerset, Middlesex, & Union. we offer a compassionate, client-centered approach to caregiving Whether a client needs 24/7 support, hourly care, or a daily visit for medication management, we will...
Our goal is to promote independence for our clients by providing compassionate care in the comfort of their homes. patient Often individuals require assistance with one or more of their activities of daily living such...
At iSmart Home Care, our personalized care plans and linkages are essential and provide benefits that are indeed crucial aspects of providing effective home care. We do it the SMART way for those in need of our services.
Our mission is to support the health and well-being of our clients by delivering the finest personalized in-home care, specific to their needs, wants and preferences
Wayne and Tricia Sarrow started Senior Helpers of Madison in 2007 to deliver the best possible in-home care to seniors in Morris, Essex, and Union counties. Our proprietary training and education programs ensure your...
Preferred Care At Home of Northeast New Jersey is a home care provider that services in Westfield, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We welcome you to Amazing Grace Home Health Care, "Your Extended Family in Home Care". Numerous families provide care and support for their loved ones during their times of need. As the population of 65+ and disabled...
At FirstLight, we understand that you and your loved ones deserve a compassionate caregiver who is committed to helping you have your best day, every day. That’s why our home care assistance is about establishing caring...
Home Helpers® Home Care is a in-home care service that provides top quality in-home care. Our Cared-4℠ program is a holistic approach to meet the four primary areas of need, helping your loved one stay safe and...
At First Day Home Care - New Jersey, our mission is to provide compassionate, high-quality, and personalized home care services that enhance the independence, dignity, and overall well-being of our clients. We are...
Family First Homecare is a home care provider that services in Westfield, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our commitment is based upon a deep concern for the health, comfort and needs of our clients, whether at home, in the hospital or nursing home. Our values are simple. We are strongly committed to our community, our...
At Izabella Home Care, we are dedicated to providing the highest level of care for your loved ones. Our mission is to support individuals in maintaining their independence and well-being in the comfort of their own homes....
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...
Amorycare Homecare was created based on the idea that forming a family-like bond between caregiver and client is the key to providing New Jersey families with the highest quality home health care experience. Amorycare...
Haven Home Care Services is a home care provider that services in Westfield, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
JC Care is the most reliable Home Health Care Service in the New Jersey area. Our practitioners provide the best home health care services and cater to the specific needs of each client. We bring high-quality care right...
Right at Home of Morris & Union Counties helps people stay in their home or in their Assisted Living Community. We believe that maintaining an independent lifestyle fosters the dignity and sense of purpose we all seek....
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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.