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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.
✔
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:
Senior Solutions is a non-medical comprehensive home care agency that trains caregivers who assist our clients with activities of daily living in their own homes. In recent years, we have also added service lines to help...
At Aiko Home Care, our mission is to provide exceptional, compassionate, and reliable non-medical in-home care to the residents of Cobb, Douglas, and Paulding counties. We are dedicated to enhancing the quality of life...
Graceful Care Solutions offers a full suite of home support services, delivered by caring and dedicated caregivers. We focus on creating individualized care plans, ensuring that our team is skilled and capable, and...
We know there’s no place like home. That’s why we bring the highest quality of care right to your front door. With a personalized care management approach and a dedicated team of compassionate caregivers, you can expect...
Charlotte Web Private Home Care, LLC is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Maurina Homecare Agency was founded by a Family Nurse Practitioner and a military servicing member. Having worked in the healthcare field, I have witnessed the essence of providing high-standard care in the comfort of...
Place Of Joy Home Care Agency is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ARM Home Care is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Candid Hearts Healthcare Services LLC is a non-medical home care agency based in Acworth, Georgia. The agency is dedicated to providing compassionate and personalized care to seniors and individuals with disabilities who...
Atlantic Medical Professionals, LLC is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ULTIMATE CHOICE STAFFING LLC is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentle Springs Health Care Services, LLC is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Righteous Hands Personal Care Agency, we pride ourselves on providing exceptional in-home care services throughout Georgia. We understand the importance of offering compassionate and purposeful care to our clients.
Acti-Kare is a leading in-home senior care company that has been trusted for over a decade. Our caregivers are insured, bonded, and trained which means you will receive a trusted and professional caregiver every time....
Godwins Family Care LLC is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
For over 50 years, Interim HealthCare has been personalizing care to meet the unique health needs of our clients, patients, and partners. Our team’s standard of care is centered around HomeLife Enrichment, our unique...
Around the Clock Homecare is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Faith Living Legacy LLC is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
FREGO HOMECARE INC is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TLC Senior Care is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
For as much or as little as you may need, FAVOR is with you. We offer a variety of services that includes Personal Care Aide (PCA), Certified Nursing Assistant (CNA), Skilled Nursing (LPN,RN) as well as individual...
MARIEL'S HEALTHCARE SERVICES, LLC is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
PON HEALTH LLC is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Favor Health Care Services is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Penny Health Services is a home care provider that services in Acworth, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With extensive clinical healthcare experience, we offer levels of service ranging from sending certified nurse aides to nursing functions that are performed under doctor orders. Our agency is clinician-owned, and whatever...
MainSpring Home Care is committed to providing high-quality, affordable, and compassionate Private Home Care Services that meet the needs of our clients and their loved ones in the comfort of their own homes.
At Senior Helpers Marietta, we provide compassionate, personalized in-home care to help seniors live safely and comfortably where they belong—at home. Locally owned and deeply rooted in the Marietta and Kennesaw...
At Home Matters Caregiving of North Atlanta, we provide homecare that strives to keep our clients as independent as possible; improving quality of life, longevity and provide peace of mind.
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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.