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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 provide non-medical, aide services and companion care to seniors, elderly, and physically challenged adults. Through coordinated care and support for clients and their families, we enable our clients to live at home...
Regardless of your age or physical ability, caring for someone can be exhausting, especially when you have a busy life to maintain. Rather than letting important tasks and stress pile up, turn to a name that’s backed by...
At Grace Community Services, we are dedicated to delivering premium home healthcare services with transparency, security, and genuine compassion. Our innovative approach combines cutting-edge technology and a commitment...
YourVision Home Care is more than an agency; it's a promise of compassionate support, fostering a sense of belonging, and enriching the lives of those we serve. With open hearts and skilled hands, we embark on this...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Zieglerville, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
At Healthspan Partners we specialize in delivering personalized home care services to individuals and families in Philadelphia and Delaware counties. We understand the importance of independence and dignity for our...
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...
Here at Caring Hands of Humanity LLC, we aim to improve the quality of care in our community. We provide a individualized approach, and lead with compassion. It is our doctrine to ensure that all core values are met, such...
Fidelity Home Care is a trusted provider of compassionate, high-quality in-home care services for individuals in need of assistance with daily living activities. With a strong commitment to personalized care, Fidelity...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Zieglerville, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Through personal care plans with Comforcare Home Care services, our office can determine the best plan of individual care based on your families specific needs. Our dedicated caregivers can be available for as little as a...
Our Services. At 5karats of love we provide... In home care Personal care Non skilled care Monitor vital signs accompany doctor appointments Warm companionship Meal preparation Light...
As we strive to offer companionship and holistic support for our clients, Jovial Care Givers works to enhance the quality of life for your loved ones while providing reliable in-home non-medical care in Pennsylvania.
Allegiant Home Healthcare is a family owned and operated non-medical home care company. We have a combined 35 years of experience in the home and health care industry. Our experience, expertise and loyalty to the...
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...
Our home care agency provides essential in-home support services to seniors and individuals with disabilities, helping them maintain independence and quality of life. We offer assistance with daily activities such as...
We provide non-medical, aide services and companion care to seniors, elderly, and physically challenged adults. Through coordinated care and support for clients and their families, we enable our clients to live at home...
Regardless of your age or physical ability, caring for someone can be exhausting, especially when you have a busy life to maintain. Rather than letting important tasks and stress pile up, turn to a name that’s backed by...
At Grace Community Services, we are dedicated to delivering premium home healthcare services with transparency, security, and genuine compassion. Our innovative approach combines cutting-edge technology and a commitment...
YourVision Home Care is more than an agency; it's a promise of compassionate support, fostering a sense of belonging, and enriching the lives of those we serve. With open hearts and skilled hands, we embark on this...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Zieglerville, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
At Healthspan Partners we specialize in delivering personalized home care services to individuals and families in Philadelphia and Delaware counties. We understand the importance of independence and dignity for our...
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...
Here at Caring Hands of Humanity LLC, we aim to improve the quality of care in our community. We provide a individualized approach, and lead with compassion. It is our doctrine to ensure that all core values are met, such...
Fidelity Home Care is a trusted provider of compassionate, high-quality in-home care services for individuals in need of assistance with daily living activities. With a strong commitment to personalized care, Fidelity...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Zieglerville, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Through personal care plans with Comforcare Home Care services, our office can determine the best plan of individual care based on your families specific needs. Our dedicated caregivers can be available for as little as a...
Our Services. At 5karats of love we provide... In home care Personal care Non skilled care Monitor vital signs accompany doctor appointments Warm companionship Meal preparation Light...
As we strive to offer companionship and holistic support for our clients, Jovial Care Givers works to enhance the quality of life for your loved ones while providing reliable in-home non-medical care in Pennsylvania.
Allegiant Home Healthcare is a family owned and operated non-medical home care company. We have a combined 35 years of experience in the home and health care industry. Our experience, expertise and loyalty to the...
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...
Our home care agency provides essential in-home support services to seniors and individuals with disabilities, helping them maintain independence and quality of life. We offer assistance with daily activities such as...
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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.