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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:
Our motto “Commitment To Serve” applies to all the services offered through Charter Oak Home Care. Family and veteran owned and operated since 1985 we are dedicated to serving older adults in our community. From...
United Federal Home Care is made up of professional caregivers in Connecticut area. Our friendly caregivers are kind, proactive and trustworthy. We handpick each of our caregivers to ensure we have a dedicated and loving...
ElderCrew delivers the pinnacle of personalized care with our high-quality private duty aides, dedicated to enhancing lives both at home and in assisted living facilities.
Our family owned company was established in 1989 in New Britain, CT as Bright Cleaning Services with the intentions of providing housecleaning services in central Connecticut – Newington, Middletown, Avon, Glastonbury and...
Mercy Home Health Inc. is a home care provider that services in Bristol, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Homewatch CareGivers of Bristol-Farmington, we believe everyone deserves to feel secure and supported in the comfort of their own home. Serving the vibrant community of Farmington, CT, we provide compassionate...
There’s a reason why Unity Home Care LLC, is a leading provider of homecare in Farmington, Connecticut, and that’s simply because we truly care for you! Elderly, injured, ill, and the disabled—we make every high-quality...
Care At Home by JFS, LLC, Compassionate In-Home Care Services At Care At Home by JFS, LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
The mission of CareCo Shoreline is to provide comprehensive, compassionate, and customized in-home services designed to help individuals remain in their homes, safe and strong.
Oxford Home Care was founded upon the goal to provide an exceptional brand of care that helps the elderly, the sick, and the disabled members of our communities remain and stay healthy in their own homes. We recognize how...
Pronatural Home Care is a home care provider that services in Bristol, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At H0PE ALIVE HOME CARE AND COMPANION, we’re dedicated to providing the support needed to ensure your loved ones receive the quality care and quality of life they deserve.
The mission of CareCo Shoreline is to provide comprehensive, compassionate, and customized in-home services designed to help individuals remain in their homes, safe and strong.
For those who want to continue living at home but need help with day-to-day tasks, VJ Health Care Services. offers different levels of personal assistance to keep seniors safe and sound at home With the progression of...
The Townsend Agency Home Care LLC proudly provides non-medical home care services for the whole state of Connecticut! At the Townsend Agency, we believe in transparent pricing. Unlike most agencies that will not provide...
Greater Bristol VNA is a home care provider that services in Bristol, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
M.R. HomeCare is a home care provider that services in Bristol, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Affectionate Homecare Agency Inc. is a home care provider that services in Bristol, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Morning Star Home Care provides personal care assistant and companion care services to seniors, elderly, mentally challenged and physically challenged adults. Through coordinated care and support for clients and their...
Voted "Best in Home Care" in 2007 (Connecticut Law Tribune) Care Management Associates, a division of Connecticut Community Care, Inc., provides in-home assessments statewide, phone and office consultations on elder...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Bristol, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Viera Homecare is your leading provider of world-class homecare services in Connecticut. We specialize in helping seniors maintain their independence while providing peace of mind to their families and loved ones. We also...
At SENIOR HELPERS of Upper Fairfield, New Haven, and Central Connecticut, we are dedicated to supporting families in our community with personalized care, no matter how big or small the task. Our mission is simple: to...
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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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.