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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:
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Nu Care is the perfect solution for seniors and others in need who are not ready to leave their home for an institutional setting, but need support to remain at home. We improve your life by providing compassionate,...
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HomeCare Professionals - South Bay Office, CA is a home care provider that services in Campbell, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Indeed provides non-medical home care services to seniors: personal care, support with mobility, help with household chores, companionship, and transportation. We also send our trained and experienced caregivers,...
Amita Dhingra, owner of Amada Senior Care Cupertino views her role as part of a larger commitment to our population of cherished seniors in Campbell, Cupertino, San Jose, Santa Clara, and Saratoga. Amita understands the...
On Lok PACE is a full-service healthcare program that provides the services you need to age at home. Our services include home care, medical, transportation and other senior services. On Lok PACE: Empowering you to live...
Our dedicated team provides heartfelt care, ensuring every senior feels valued and supported. Every individual is unique, so is our care. We tailor support to fit every senior's needs and lifestyle. Comfort and security...
Serving and supporting the communities of the Peninsula and South Bay (San Francisco Bay Area) At SYNERGY HomeCare we believe that everyone deserves the opportunity to live a purposeful, connected, and healthy life. We...
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Nurse Next Door - Santa Clara, CA is a home care provider that services over 40+ zip codes across Santa Clara County. Home care services allow seniors to remain safely in their own home while receiving medical care or...
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When it's time to find home care in San Jose for a beloved family member, choosing the right caregiver is crucial. Compassionate, professional care can make all the difference in ensuring your loved one's well-being and...
Caring for adults of all ages, in their communities and in their homes With over 45 years combined experience in the Senior Care business, Affordable Senior Care’s management team has the wisdom, knowledge and...
1Heart Caregiver Services in Campbell, CA, provides personalized, non-medical home care solutions designed to enhance the quality of life for seniors and individuals needing assistance. Their trained and compassionate...
Caresouth Homecare Professionals is a home care provider that services in Campbell, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Executive Home Care Of Silicon Valley- South Bay is a home care provider that services in Campbell, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
California Seniors Care (CSC) was founded by Del and Mercy Broberg in 2002 after owning and operating several care facilities for the elderly in San Jose, CA. Over 20 years after running the care homes, CSC was founded to...
Okeha Senior Care is a home care provider that services in Campbell, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SCC At Home LLC, Compassionate In-Home Care Services At SCC At Home LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence. Our mission is...
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
SpeedCare LLC is a leading mobile app-based caregiver matching service provider. Founded by three highly passionate pillars in the healthcare industry in 2021 in response to the challenges of the pandemic, our mission is...
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Home Instead - Campbell, CA - Duplicate is a home care provider that services in Campbell, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All Seasons Homecare provides assistance to those who need help with everyday tasks because of illness, surgery, or a chronic condition, yet treasure their independence and want to enjoy the comfort of their own homes. We...
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Special Hearts Homecare, Inc is a home care provider that services in Campbell, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Recruit RN, Inc. is a home care provider that services in Campbell, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
RCR STAR MANAGEMENT OF SAN JOSE, INC. is a home care provider that services in Campbell, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
California Seniors Care-Campbell is a home care provider that services in Campbell, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
No matter their needs, our personalized in-home services help your loved one remain where they feel safe and help them actively engage in leading an enriched life.
SpeedCare LLC is a leading mobile app-based caregiver matching service provider. Founded by three highly passionate pillars in the healthcare industry in 2021 in response to the challenges of the pandemic, our mission is...
For over 15 years, Senior Helpers has been there to help anyway we can -- no matter how big or how small the task. Our owners, Shad Schidel and Alay Yajnik, know personally what it's like for the people in need of care...
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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.