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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:
Quality Private Home Care Services is a trusted and compassionate home care agency dedicated to enhancing the lives of individuals in need of personalized assistance.
When seniors, or recovering individuals, need short or long-term care, home is always the best place for the healing to begin. With Cottage Caregivers, you can offer an aging care place for mom and dad that has the daily...
Since 2007 Right at Home South Shore has been providing superior non-medical in-home care services to seniors and disabled adults throughout the South Shore. Our trained caregivers offer round-the-clock care for seniors...
Robert and Daniel Appel, owners of Amada Senior Care Boston MetroWest, know from personal experience the difference quality care can make in the lives of seniors and their families. Says Robert, “Now, having seen how big...
Boston Nursing Care & Consulting cultivates a modern healthcare experience, which provides our clients the knowledge and education to fully understand their conditions.
By choosing Senior Helpers for a loved one, you’re not just getting exceptional care for any of their needs, but you’re gaining a genuine, in-home connection designed to give them the absolute best quality of life. We...
At Homily Care Agency, we offer a wide range of health care services for disabled and elderly individuals in the comfort of their own homes. Our dedicated team ensures that our clients receive the best care and attention...
Welcome to AC1 HomeCare, your trusted partner in non-medical in-home care services in Braintree and surrounding areas. Located at 288 Grove Street, Ste. 302, Braintree, MA, our agency is dedicated to providing...
At it’s core, our in-home senior care service is about bringing warmth, friendship, and the highest quality of care right into the comfort of your home. More than just lending a hand, we’re here to share laughs,...
Home health care helps older adults live independently for as long as possible, even with an illness or injury. At HSH, we offer home health care that is both medical and non-medical in nature, including chores and light...
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...
BrightStar Care offers a wide variety of high-quality services—from in-home care to medical staffing. If you are looking for a trustworthy care provider or staffing partner in the Greater Boston & Metro West, MA area,...
We are a recognized agency providing Home Health Care wherever a client lives in Eastern Massachusetts. We are also Alzheimer's specialists. The service can be a few hours or 24 hours. We offer Live-in, hourly,...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Brockton or in surrounding areas across Plymouth County.
Guardian Angel Senior Services - Braintree (Duplicate Do Not Use) is a home care provider that services in Braintree, MA. Home care services allow seniors to remain safely in their own home while receiving medical care...
Guardian Angel Senior Services - Braintree is a home care provider that services in Braintree, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
South Shore Visiting Nurse Association is a home care provider that services in Braintree, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
North River Home Care’s highly experienced and dedicated care staff serves clients with a variety of needs to help your loved one remain at home, including: Personal & Companionship Care, Respite Care and Alzheimer’s and...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Braintree, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It is our vision to be the best support system that eases pain for families going through the challenges of caring for their declining loved ones. We also work to facilitate opportunities for compassionate caregivers...
KinCare at Home is a family owned and operated home care and companion agency. We will treat your family with dignity and respect and provide the highest level of care and companionship possible. Our community of...
Havenova Home Care – Your Extended Family, When Family Can’t Be There At Havenova Home Care Solutions, we prioritize family and provide compassionate care to help you focus on what matters most—cherished moments with...
Welcome to Home Helpers of the South Shore!At Home Helpers, we are committed to providing non-medical personalized care to help our clients in their daily lives whether they reside at home or in a facility. We pride...
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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.