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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:
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...
When it comes time to look for home care services for your loved one, you want to be sure that you’re making the best decision. Our senior home care teams in Arvada offer more than just care for your loved one’s...
ACASA Senior Care - Denver, CO is a home care provider that services in Wheat Ridge, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
We aspire to be the preeminent home care agency in the Denver Metro area focusing on safety, lifestyle enhancement, and positive outcomes to help seniors continue to age in the comfort of their own homes. Talem Home Care...
More than 90% of seniors want to age in their own home with dignity but getting the right type of care can seem daunting. At Senior Helpers Denver North we believe getting the best care for your loved ones should not be...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in the Mile-high City or in surrounding areas.
At HomeWell Care Services, we provide live-in and hourly at-home care for seniors, the elderly and others who are struggling to manage day-to-day activities like grooming, bathing, cooking, or even running errands. Our...
For the members of our team at Amada Senior Care Denver West, providing in-home senior care is much more than just a job; it is a fulfillment of our personal goal to enrich the lives of our clients at every level. Whether...
Friends For Life, Inc.'s mission is to assist seniors and to support families. The pressures of work, family, and long distances can make caring for elderly loved ones a daunting task. While, at the same time, aging...
Visiting Angels can customize care to meet all of your loved one's needs. Our services are designed to provide compassionate care so your elder loved one can continue to live at home. Our senior home care providers are...
Professional Home Health Care Denver, CO is a home care provider that services in Wheat Ridge, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Reliable Home Health Services Inc is a home care provider that services in Wheat Ridge, CO. 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,...
Where and how you receive care matters. Interim HealthCare has pioneered the way care is delivered through a home-based, flexible care model that combines clinical expertise, innovation and experience with highly...
At Home Care Assistance, our mission is to change the way the world ages with our home health care services. We provide older adults with quality home health care in Denver, that enables them to live happier, healthier...
FirstLight Home Care of Denver Southwest offers complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just needs a little assistance. And with our trusted,...
Staying at home isn't always the easiest path for those who live with physical or mental limitations. It can be difficult for the entire family. Griswold Home Care for Westminster, Broomfield & Boulder is here to help you...
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...
When it comes time to look for home care services for your loved one, you want to be sure that you’re making the best decision. Our senior home care teams in Arvada offer more than just care for your loved one’s...
ACASA Senior Care - Denver, CO is a home care provider that services in Wheat Ridge, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
We aspire to be the preeminent home care agency in the Denver Metro area focusing on safety, lifestyle enhancement, and positive outcomes to help seniors continue to age in the comfort of their own homes. Talem Home Care...
More than 90% of seniors want to age in their own home with dignity but getting the right type of care can seem daunting. At Senior Helpers Denver North we believe getting the best care for your loved ones should not be...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in the Mile-high City or in surrounding areas.
At HomeWell Care Services, we provide live-in and hourly at-home care for seniors, the elderly and others who are struggling to manage day-to-day activities like grooming, bathing, cooking, or even running errands. Our...
For the members of our team at Amada Senior Care Denver West, providing in-home senior care is much more than just a job; it is a fulfillment of our personal goal to enrich the lives of our clients at every level. Whether...
Friends For Life, Inc.'s mission is to assist seniors and to support families. The pressures of work, family, and long distances can make caring for elderly loved ones a daunting task. While, at the same time, aging...
Visiting Angels can customize care to meet all of your loved one's needs. Our services are designed to provide compassionate care so your elder loved one can continue to live at home. Our senior home care providers are...
Professional Home Health Care Denver, CO is a home care provider that services in Wheat Ridge, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Reliable Home Health Services Inc is a home care provider that services in Wheat Ridge, CO. 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,...
Where and how you receive care matters. Interim HealthCare has pioneered the way care is delivered through a home-based, flexible care model that combines clinical expertise, innovation and experience with highly...
At Home Care Assistance, our mission is to change the way the world ages with our home health care services. We provide older adults with quality home health care in Denver, that enables them to live happier, healthier...
FirstLight Home Care of Denver Southwest offers complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just needs a little assistance. And with our trusted,...
Staying at home isn't always the easiest path for those who live with physical or mental limitations. It can be difficult for the entire family. Griswold Home Care for Westminster, Broomfield & Boulder is here to help you...
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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.