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.
✔
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:
Elroi Care Home LLC offers professional support services that allow individuals to live safely and comfortably in their homes regardless of age, physical, medical or emotional conditions.
At Prestige Loving Home Care, we are committed to delivering exceptional service to your loved ones. With a dedication to personalized care, we ensure every client experiences comfort and peace in their home and lives an...
We are driven by one ultimate goal and that is to serve the people in our community by providing them with dependable home care in Indianapolis, IN, that allows them to minimize or avoid hospital, rehab, or nursing home...
At Precise Home Care Agency, we believe care should be personal. Our skilled and compassionate team provides reliable in-home support—from help with daily routines to companionship and specialized care—empowering clients...
We’re intentionally different. We set the benchmark for excellent home care by balancing our friendly nature, person-centered approach, and discreet services with our love of helping you maintain your independence. It’s...
Patient Hands strives to always remain personalable and relatable to the clients we serve. We strive to provide one on one care to make our clients activities of daily living as easy as possible. We like for our...
At Loving Touch LLC, we are committed to enhancing the quality of life for our clients by providing compassionate and personalized care. Our services are designed to support daily living, promote independence, and ensure...
We Make A Difference In Senior Lives At Happy Homes Homecare, we are dedicated to providing exceptional in-home care for seniors. Our mission is to ensure that every senior receives the care, respect, and companionship...
Golden Heart Senior Care offers the highest quality companion care, home care services and personal care services so our clients can live a full and independent life in the comfort of their home.
At Elevated Care with Compassion Inc., our mission is to provide exceptional, patient-centered healthcare that nurtures the whole person—mind, body, and spirit—through a seamless blend of professional expertise,...
At Vesta Structured Family Care, we extend beyond traditional care services; our foundation is built on compassion and a personalized approach to support. We are passionately focused on serving seniors, driven by a...
Companion Care The goal of companion care is primarily emotional support, socialization, caregiver assistance, light housekeeping, and companionship to help senior and elderly adults function independently in their own...
SYNERGY HomeCare of Northern Indianapolis is owned and operated by Trent Terry, a Master’s graduate in Business Administration who has since put his degree to use in multiple successful entrepreneurial ventures, ranging...
CJ Homecare LLC is a trusted provider of non-medical in-home care services, dedicated to improving the quality of life for seniors and individuals with disabilities or chronic conditions. Our compassionate caregivers...
Supporting Seniors and Families with Reliable, Loving, and Personalised Homecare At Warming Hearts At Home Care, we specialise in providing trusted and compassionate in-home care services in Indiana for seniors and...
At Divine Care Solutions LLC, we are dedicated to providing compassionate, personalized home care services that promote dignity, independence, and peace of mind. Whether you or your loved one need assistance with daily...
A-1 Personal Services Agency in Indianapolis, Indiana, is a licensed, Medicaid-certified home care provider offering personalized non-medical services like personal care, companionship, homemaking, and respite care....
At One Trusted Homecare we are dedicated to providing exceptional care and support to individuals and families in the comfort of their own homes. Our compassionate and experienced team of caregivers is committed to...
Established in 2021, MAGNIFICENT HOMECARE LLC pays homage to the owner’s late sister, who courageously battled SMA and required constant in-home care. Her enduring journey profoundly inspired the core mission of our...
At Amada Senior Care of Greater Indianapolis, our goal is to walk with seniors and their loved ones through every step of their senior care journey. They are committed to preserving dignity and giving families the peace...
Age in Place Home Care of Brownsburg, IN is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Generation Of Joy Home Care, Compassionate In-Home Care Services At A Generation Of Joy Home Care, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
**PNA Nurturing Care Service LLC** in Brownsburg, IN, provides non-medical home care services, offering personalized assistance with daily living activities and companionship to seniors and individuals with disabilities....
Hope Group Homecare Agency is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Recovering from home after surgery can limit you with your daily activities. Whether you are recovering from major surgery childbirth or in needed of Personal care Let Corinthians assist you to a healthy and complete...
Shalom Care LLC provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily tasks, medical support, and companionship, creating a...
HEART OF ANGELS LLC is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
4SEASONS HOME CARE LLC is a home care provider that services in Brownsburg, IN. 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....
TopCare Home Care is dedicated to providing compassionate and personalized in-home care services that support individuals in maintaining their independence and quality of life in the comfort of their own homes. With a...
A Lending Hand Home Care is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Forever Golden Homecare LLC is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At TMC Homecare, LLC, our mission is to deliver exceptional, compassionate homecare services that promote the health, independence, and dignity of our clients.
Moonlight Homecare Services provides personalized in-home care for seniors and individuals requiring assistance. Our compassionate caregivers support daily activities, promote independence, and enhance quality of life,...
REQUEST PERSONAL HOME CARE LLC is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
KD ESSENTIAL HOME CARE LLC is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OHS HOME CARE LLC is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
LIFE CHANGES IN HOME SENIOR CARE & TRANSPORT, LLC is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homewatch CareGivers of Brownsburg, IN is a home care provider that services in Brownsburg, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CORNERSTONE CAREGIVING IN INDIANAPOLIS, INDIANA We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Indianapolis or in surrounding areas like...
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...
Our mission at Yay Bella Homecare Agency is to provide exceptional non-medical in-home care services that promote independence, dignity, and quality of life for our clients. We are dedicated to delivering compassionate...
Senior Helpers Indianapolis helps families navigate the full continuum of senior care. Our in-home aides allow seniors to receive the day-to-day help with personal care they need and assistance with activities of daily...
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.