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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
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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:
Personal care focuses on hands-on assistance with daily tasks like bathing, dressing, and mobility, while companion care emphasizes social interaction, emotional support, and light household tasks
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...
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...
We’re here to help you continue living independently. If you or a loved one is having trouble with activities of daily living, home safety or personal care, we can provide a specialized program to make life easier and...
Home Helpers Home Care of Naperville is among the best in home care today. We only hire caregivers who are really passionate about their jobs. We make sure all our caregivers are properly trained and have undergone...
Our Vision Our vision is to be the leading provider of homecare services, known for excellence in care and innovation. We strive to ensure that every senior has access to the support they need for a fulfilling and...
Resurrection Home Care LLC is a leading provider of in-home care services in the United States. Our mission is to provide compassionate and personalized care to seniors, individuals with disabilities, and those recovering...
Caring From the Heart LLC is a home care provider that services Chicago, IL 60634. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
Optimum Senior Care Optimum Senior Care offers in home senior care and caregiver services to the elderly population in the Chicago Metro area. Our mission is to cherish and protect the independence and dignity of our...
As a provider of home care services in Bloomingdale, Illinois, we are committed to providing compassionate home health care rooted in the values of doing what is right and noble. Inspired by the Hebrew word “Mishle,”...
We replace nursing homes with in-home care. We ensure your parent or loved one is taken care of; from grocery trips, home chores and nutrition planning all the way to non-medical administration. We're your 'eyes and ears'...
When the time comes that extra care is required, whether due to age or health condition, many people prefer the familiarity and comfort of their own home. At Homewatch CareGivers®, we believe that good care should not...
Perennial Home Care Services LLC is a home care provider that services Chicago, IL 60634. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care...
Ever Caring Home Health Nursing Agency is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Avita Home Care Inc, our mission is to enhance the quality of life for our clients by providing compassionate and personalized home care services. We are dedicated to fostering independence, dignity, and well-being...
Crystal Care of Illinois Inc provides services in private homes, assisted living communities, skilled nursing facilities, and rehab centers. We understand that the relationship between the client and the caregivers...
Will Staff Inc is a home care provider that services in Arlington Heights, IL. 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...
At LifeStyle Options, we take pride in being the trusted source for home care services throughout Illinois. With more than 30 years delivering exceptional private duty service, we have the experience and resources that...
Advanced Family Home Health 1, Inc is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Your Light At Home LLC is a home care provider serving Arlington Heights, IL 60004. Their services enable seniors to remain safely in their own homes while receiving medical care or assistance with personal care and other...
Compassionate In-Home Senior Care in Arlington Heights At Liv Safe Home Healthcare, we are dedicated to providing high-quality, personalized in-home care for seniors in Arlington Heights and the surrounding communities....
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,...
Our founders exemplified the philosophy behind Inspired Home Care, a trusted home care agency for seniors in Chicago and the surrounding areas. Amit Shrivastava grew up in India and watched his mother care for her own...
Care Services of Illinois, LLC is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CORLAN HOME SERVICES INC is a home care agency specializing in comprehensive services to meet varied individual needs. In-home care is a great way to get the help you need. Our Home Care services are versatile, flexible,...
4 Seasons Home Healthcare Services Corp is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Center Of Illinois Home Healthcare, Inc is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Northwest Community Hospital H is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Optimum Senior Care - Palatine, IL is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Absolute Home Care, LLC of Arlington Heights, IL is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Exceptional care starts with an exceptional team. That’s why we go beyond standard hiring practices, selecting caregivers who embody empathy, professionalism, and a passion for making a difference.
LIV Home Health LLC of Long Grove, IL is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Samaritan Healthcare, Llc is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
For Papa's Sake Home Care for Families is the perfect solution for seniors and those with physical challenges. We improve your life by providing compassionate, one-on-one care in the comfort of your own home. We stay...
Our trained, dependable in-home caregivers and personal assistants can help overcome those challenges and make the home an even better place to be. Our home care services include everything from elderly/ senior care,...
FirstLight HomeCare of Northwest Suburban Chicago is committed to helping our clients remain independent and safe in the comfort of their home, and to champion quality of life for all seniors. We provide both companion...
We believe in rendering affordable and efficient home healthcare to everyone who is need of such. Home healthcare should not be accessible to select individuals only, but to all who have a right to life. Vision: Goshen...
Vision & Mission At FirstLight Home Care, we envision a world in which all adults may age with comfort, dignity and independence in the place they call home. We exist to help people have their best day, every day. Our...
Senior Helpers of Greater Chicagoland is the premier provider of in-home senior care. We offer tailored home care services ranging from companion care for seniors who need daily assistance to in-depth specialized care for...
Northwest Home Care, Inc is a home care provider that services in Arlington Heights, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
North Shore Compassionate Care is the ideal solution for elderly or disabled individuals who want to maintain their independence and dignity by continuing to live in the comfort of their own homes. Our home health...
We provide in-home care services in Arlington Heights, Elk Grove Village, Mt Prospect, Elmhurst, Downers Grove, Oak Brook & the surrounding areas. At Comfort Keepers Home Care, we provide compassionate and personalized...
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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.