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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:
Caregivers are extremely vital to seniors who wish to age in their own homes. At Amada Senior Care in Brookhaven, GA, we provide high-quality caregivers who provide excellent in-home care services to seniors. As a home...
At Beteli Care Services LLC our commitment is to transform the way in-home care is experienced by blending compassion, excellence, and truly personalized support. Our mission is to help individuals live safely and...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
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...
If you’ve been searching for a quality home care agency, either for yourself or a loved one’s care, then you’ve likely discovered a “sea of sameness” in the dozens of home care choices available. We know that it can be...
Anchor Healthcare LLC is a Georgia-based healthcare provider committed to delivering compassionate, high-quality, and patient-centered care. Through personalized services and a dedicated team of professionals, we strive...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Hearts of Love Caregivers helps families with non-medical in home care. We offer in home health care in select locations. With Hearts of Love Caregivers, every client receives extra ordinary care from our caring team. We...
Since 2002, Senior Helpers has been a national leader in professional in-home care services. With a vision to help seniors remain in their homes despite age-related changes and chronic medical conditions, we have now...
Charlotte Web Private Home Care, LLC is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Flamede health! We provide efficient, effective, comforting and loving short-term and long-term in-home care. We are here to care for the needs of your loved ones from Pediatric to elderly & disabled. We...
Carehaven Healthcare provides compassionate, dependable in-home support that helps clients live safely, comfortably, and independently. Caregivers deliver personalized daily assistance and warm companionship—giving...
Seniors Helping Seniors® 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...
At Dependable Homecare LLC our commitment is to transform the way in-home care is experience by blending compassion, excellence, and truly personalized support. Our mission is to help individuals live safely and...
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....
Why Choose BrightStar Home Care With an emphasis on comprehensive person-centered care, our team at BrightStar Home Care Duluth is committed to helping clients maintain their independence in the home where they feel...
Right at Home is North Atlanta's trusted quality in-home senior care provider. We create custom care plans as needs change to allow your family members to live at home as long as possible.
Connection Bridge Oasis is dedicated to empowering seniors and individuals with disabilities throughout DeKalb County and surrounding Georgia communities by providing compassionate, person-centered care that promotes...
Metro Care Partners LLC is a dedicated home care agency serving individuals and families throughout Georgia with compassionate, personalized, and reliable in-home care services. Our mission is to enhance the quality of...
2nd Family in Marietta offers in home care that feels personal, not transactional. Their caregivers support daily needs like personal care, meals, and transportation while building real relationships along the way. With...
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...
Whether providing short-term assistance or long-term support, our team is committed to enhancing well-being and fostering peace of mind for both clients and their families.
EASY LIVING SERVICES, INC is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angels Home Care Caring for Angels Home Care LLC will provide Personal Care services to individuals in their own homes and communities, who need assistance with their activities of daily living as a result of old age,...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Comfort Homecare At Home LLC is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CarePoint Home Care is an Alpharetta based agency proudly serving residents within the metro Atlanta area. We provide non-medical private duty home care services specializing in companion and hands-on personal care...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Our services range from skilled nursing and therapy services to personal care assistance and companionship, all delivered by experienced and certified caregivers who are committed to ensuring your safety, comfort, and...
Prize Home Care LLC is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A One Home Care is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aspera Healthcare Services is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tender Loving Care Staff Builders Home Health is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a private home care agency, supplying a full range of in home care services (personal care, respite care and companion care) to the senior and elder community of greater Atlanta. We offer these services both in...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
Horizon Health Care Agency is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a dedicated homecare provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity.
At Mossgate Home Care, we are committed to providing an exceptional home care experience to those in need. Our comprehensive approach helps us to enhance the living of our clients as well as their families by providing...
Victory Plus Home Care & Services is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Guardian Angels Home Care provide health care services in a private home, assisted living facility, or adult family care home. Nursing visits Give medications or help the patient give themselves medications Physical,...
Family Choice Healthcare is a licensed private homecare provider offering companion sitter, personal care support and nursing services to medically fragile and elderly individuals throughout Georgia.
Amanda Smith, Kiu Smith, and Michelle DeHaarte, the owners of Amada Senior Care Cumming, GA view their role as part of a larger commitment to our population of cherished seniors in Jasper, Tate, Ball Ground, Canton, Holly...
Judy's Private Home Care LLP is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Let Home Helpers of Alpharetta (Serving Cumming) Create a Customized Home Care Plan to Fit Your Lifestyle! Live life your way in the comfort of home with Home Helpers of Alpharetta. Whether you’re a family caregiver...
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...
At Sarah's Angels In Home Care, we pride ourselves in delivering top-notch quality care for your loved ones. Each of Sarah’s Angels are driven by personal journeys traveling down the path of caring for others. Our mission...
At Regency Home Care of North Atlanta, there is no higher priority than the health and safety of our clients. When a loved one requires extra care and assistance, turn to Regency’s certified expert care staff, because...
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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.