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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:
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...
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...
Our dedication is you. With 45 Years of Experience in Home Care, we are dedicated to providing comprehensive, compassionate, and personalized care. Our mission is to provide high quality, compassionate care to our...
The Harbor Health Elder Service Plan offers a personalized healthcare program provided by our own geriatric professionals guided by a care plan developed and customized for the individual’s needs.
Luthas Heath Care is dedicated to providing compassionate and professional home care services to seniors and individuals with disabilities. We understand the importance of independence and aim to support our clients in...
With a team of highly skilled, certified, and insured caregivers and nurses, we offer 24/7 care that is tailored to meet your unique circumstances. Discover why so many families in the South Shore area turn to MyCare for...
Home Instead of Norwood is a locally owned and operated office of the world’s trusted source of homecare services for seniors. Our mission is to enable seniors to live happy, healthy, safe and independent lives in...
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...
Our leadership team holds decades of expertise in the senior home care industry. Their passion for this field has motivated them to design an organization that prioritizes consistent, dependable care standards for you and...
OUR MISSION STATEMENT: We aim to provide home care services that are tailored to each of our client’s individual needs, and at the same time, preserve their freedom to choose and their sense of dignity as we offer our...
With over 15 years in the healthcare sector, our expertise spans various domains, encompassing hospital care, group homes, assisted living, and pharmacy operations. Our diverse experience has equipped us with a...
Boston Nursing Care & Consulting cultivates a modern healthcare experience, which provides our clients the knowledge and education to fully understand their conditions.
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...
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,...
Caring R Us Homecare & Nursing Staffing Agency, LLC is a leading provider of home care solutions that best suit your needs or that of your loved one. Our agency is staffed with the best professionals in the state. We work...
Traditions Home Health Services is your trusted partner for in-home health care. Our dedicated team offers a wide range of caregiving services, home health care services, and live-in care designed to cater to the unique...
ComForCare Home Care - Canton, MA is a home care provider that services in Canton, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hebrew Seniorlife - Home Health Care is a home care provider that services in Canton, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Traditions Home Health Services, we understand the importance of providing personalized care for your family members. Our team is dedicated to offering comprehensive in-home health care services, specializing in home...
Your loved ones are in good hands with us. We are an HCA accredited in-home care provider. Our job is to ensure that your mother, father, sibling, or child feels happy, safe, and cared for. Our goal is to enable YOU to do...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Canton, 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...
Your Extended Family When Family Can’t Be There At Home Helpers Home Care, we’re here to do exactly what our name says: help. We’re more than an in-home health care agency – we’re your extended family when family can’t...
Latest News: Won the 2019 Best of Home Care, Provider of Choice and Leader in Excellence Awards Find In-Home Care That’s Right for You ... Companion Care - In-home companion care helps seniors stay socially active and...
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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.