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:
Helping you when you need it most is what we do best. At FirstLight Home Care of Austin, our focus is on helping adults of any age live a better life through our reliable care services. As a leading home care provider,...
Abba Legacy Home Care is devoted to delivering top-quality in-home care services, helping seniors maintain their independence and enjoy a fulfilling lifestyle in the comfort of their own homes. The company specializes in...
Local owners Moire and Frank Hayes are deeply committed to providing the best possible in-home care to seniors in the Round Rock and Central Texas area. Moire directs the Care Team and ensures the correct plan of care is...
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....
Always Best Care combines national strength and standards with local accessibility and personal service. Your local Always Best Care team will be helping families throughout Greater Austin and surrounding areas to provide...
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...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
Core Values We live these core values every day, without compromise. It is what we believe in above all else as they guide our home care company and team members to help us achieve our mission.
Home Helpers® Cared-4 program covers every need to keep someone independent and comfortable at home. Our services include Personal Care & Companionship, Nutrition and Well-Being, Safety and 24-Hour Monitoring and Wellness...
Elder Home Care of Austin, TX is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Genuine Global Care is a top provider of in-home senior care. Our caregivers are highly trained and experienced in providing top-quality care. We provide a wide range of services, including companionship, personal care,...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in South Austin or in surrounding areas like Onion Creek, Rollingwood and Bee Cave. Our trusted...
We are a client first franchise. Our goal is to build lasting and meaningful relationships between caregivers and their clients. We are family operated and consider our caregivers a part of the family. Our caregivers are...
B'Zoe Home Care Services of TX is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homewatch CareGivers provides in-home care for seniors on a weekly, daily, or 24-hour basis, but our teams can also assist with individuals of any age, with any or condition. Get an extra set of hands around the house...
Your care needs deserve the best. Brookdale at Home is an in-home services agency with decades of experience providing care at home that’s designed to help you retain your independence longer.
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 take pride in serving Central Austin and its surrounding areas. Our dedicated caregivers not only provide exceptional in-home care services, but also create meaningful connections by learning their preferences and...
First Divine Home Healthcare Agency Inc is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Lifestyles may change with age, but the ability to maintain a safe, independent life doesn’t have to. That is why Caring Senior Service provides affordable, non-medical services and a strategic line of safety care...
Home Instead - Austin, TX is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome When seniors or adults need long or short-term assistance with their daily living needs, home is the most comfortable and convenient place to receive care. Companion Care USA provides non-medical companion/...
Halcyon Home was created to bring the most exceptional care to your home and your loved ones. Halcyon was the Greek god who calmed the seas in order to allow the mystical beautiful kingfisher bird to lay its eggs, and...
Encompass Home Health of Central Texas is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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....
C C Home Health Central Inc is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
GUCCI HEALTHCARE SERVICES INC is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DEMIU HOME HEALTHCARE LLC is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HANA CARE TEXAS is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring for aging parents and loved ones can be a challenge, especially while working to maintain your own family and work responsibilities. Although living independently, you still worry about your loved ones and their...
At Assisting Hands Home Care, we understand. Our trained & dependable caregivers and personal assistants can help overcome those challenges and make home an even better place to be. We include everything from...
Ashby Premium Home Care is a part of the well-respected Ashby Staffing Companies, operating in Austin, TX for 35 years. Our home care division is in it’s second year of business under our state license. We pride...
Home Helpers Home Care of Austin is more than an in-home health care agency: we help make life easier and more enjoyable for you and your family. We’re a locally owned, trusted provider of quality, compassionate senior...
Are you exploring care options for a loved one or family member? Our home care services bring the convenience of an assisted living center to you, in your home, giving you the sole attention of a personal caregiving...
EARTH ANGELS HOMECARE is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Continental Healthcare Inc is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Girling Community Care of Austin is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Devoted Doves Home Care, we proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff...
At Assisting Hands Home Care, our goal is to provide the highest quality of care and exceptional service. When life’s events – aging, illness, or disability – make living independently more difficult, we can help to...
Healthsouth at Home is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Assisting Hands Home Care of West Austin, TX is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Patrick Murphy, owner of Amada Senior Care Austin, Texas has had recent senior care experiences in his own family that have reaffirmed his commitment to providing the highest quality of care services for his clients in...
RedBud HomeCare Services is a small, family-owned homecare agency that has the privilege of providing care that is reliable, dependable, and hands-on. We are here to serve the needs of Seniors and their families who have...
At FirstLight Home Care of Wells Branch, we provide exceptional care so that your loved one has the support they need to enjoy the quality of life they deserve in the place they call home. We exist to help people have...
Austin Home Care is a dedicated provider of personalized in-home care services, committed to enhancing the quality of life for individuals who wish to maintain their independence in the comfort of their own homes. With a...
Life is so much more than a to-do list. It's a series of moments with the people we love, making memories that make up a lifetime. BrightStar understands this, and is committed to making more of those moments possible in...
Assisting Hands exemplifies compassion, dependability and dignity to all of our clients. Our company was founded on the principles of caring for others in a way that we would also want to be cared for which is made...
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...
Golden Heart Senior Care is a family-owned and operated in-home senior care provider. We offer hourly, live-in, and in-home services for seniors. With over 30 years of combined experience in the healthcare industry, we...
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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.