Are you sure you want to exit? Your progress will be lost.
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:
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...
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Unlike in-home care franchises, Care for SoCal is owned and operated by two nurses-an RN and an LVN-with experience in multiple specialties of nursing and in-home care, for people of all ages and circumstances. Whether...
Est 2008, Caregiver Provider in California. We provides in-home senior care, helping older adults continue to live well and independently at home and anywhere.
Alpha Homecare LLC, Compassionate In-Home Care Services At Alpha Homecare LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence. Our...
We are a dedicated healthcare 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. Based on...
Senior Helpers North-Central Orange County was founded in 2006 and purchased by owner Brian Nakamura in 2015. Brian and his staff are committed to enriching the lives of seniors in the Orange County area and providing...
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...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
Care America HomeCARE is a provider of home care in Orange County California that offers assistance to individuals with daily living and companionship. Our team of dedicated and compassionate professionals is comprised of...
Home Helpers Home Care of Orange Coast is more than an in-home health care agency – we’re your extended family when family can’t be there. We’re a locally owned, trusted provider of quality, compassionate in-home care in...
Griswold is an award-winning pioneer in the home care industry, with over four decades of experience and a storied legacy of compassion and integrity. We believe Care Professionals are the foundation of our success, and...
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
Exceptional Care for Your Loved Ones Our mission is to provide exceptional support to your loved ones in their golden years or those facing well-being challenges. Bella Vie Homecare LLC delivers premier care services...
Comfort Keepers Home Care provides seniors and their families in Buena Park, Lakewood, Bellflower, Fullerton, and the nearby areas with compassionate and individualized in-home care services that enhance their quality of...
Our in-home senior care starts with a clear understanding of who you are and what we can do to make your life a little easier and a little brighter. Whatever services you need and whenever you need them – for yourself or...
Origins Home Health Care is founded on the principles of trust, skills, and excellence in care that comes with years of experience and dedication. We are a locally owned, California based company with our headquarters...
Homewatch CareGivers of Yorba Linda, CA is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We provide affordable high-quality professional care and support for elders and children with special needs who wish to continue to live independently in the comfort of their own home but need a helping hand with the...
Infinite Love offers a wide range of customized services to meet the unique needs of your loved one. We serve the greater Orange, CA. You can rest assured that the health and comfort of your loved one will be managed with...
Best Helping Hands provides non-medical, in-home care for Seniors and any person with temporary or permanent special needs, such as Alzheimer's, Dementia, post-operative recovery, rehabilitation assistance, etc. Services...
Angels For Elders offers a comprehensive array of private home care services in Orange County and Los Angeles County. We provide home care throughout Anaheim, Costa Mesa, Irvine, Newport Beach, and beyond. Our independent...
Angel Be With Me Caregiving Service is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentle Grace HomeCare is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It is our mission to provide quality, reliable compassionate and affordable care to our clients. We understand that the vulnerability of the frail, elderly, or disabled individual requires the presence of a caregiver who...
Being an essential service provider, Amada Senior Care is here for you 24/7 as we continue to operate through COVID-19. Count on Amada’s commitment to promoting your health and safety as a factor you can control during...
St. Clare's Home Care, Inc is a home care provider that services in Anaheim, CA. 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,...
MAVI CAREGIVING SERVICES LLC is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
D'Best Care is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Horizon Support Services' goal is to meet each clients' individual needs so that they may remain in their own home where they feel safe and Familiar.Horizon Support services is dedicated to providing home care that...
HOMECARE KINGDOM SERVICES LLC is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
Comforting Care is an in-home service provider that assists individuals and families. We are dedicated to helping our clients lead dignified, independent lifestyles in the comfort and safety of their own homes by...
Graceful Day Home Care is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AL-SHIFA HOME HEALTH CARE AGENCY is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
UNITED CARE, LLC. is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Companionship is key to a trusted relationship with our Home Care Aids. We not only strive to help you with everyday tasks but want to develop a caring relationship with you. We provide one-on-one attention and care that...
ACASA Senior Care - Orange County, CA is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Altogether HealthCare and Referral Agency is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
If you want your loved ones to be genuinely cared for.... Our Mission.... is to help families keep their loved ones at home and still have the peace of mind knowing they are genuinely cared for. Our goal.... is to help...
We are a dedicated healthcare 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.
Welcome to Alderwood Home Care. We are a small family-owned boutique home health care agency. We support our clients with all their non-medical independent and daily living needs which includes companionship to seniors...
Home Sure, Inc. delivers comprehensive, personalized in-home care focused on dignity, independence, and emotional wellbeing. Whether you need daily living assistance, specialized non-medical support, or just compassionate...
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...
At Golden Years Home Care Solutions Inc – San Diego, our mission is to provide compassionate, personalized, and dependable home care services that empower seniors and individuals with disabilities to live safely,...
With Koda Caregiver personal care services, we help your relative or loved one with intimate non-medical care needs. Our companion care services provide daily companionship and assistance with daily living activities (ADLs).
Whether your loved one needs a little extra help around the house, daily medical assistance or just someone to check in with them throughout the week, Right at Home's in-home care could be the answer. Our senior Care...
At Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations 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.