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.*
✔
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:
FirstLight Home Care of Northern Kentucky is one of the most trusted home care and senior care providers in Kentucky . We are proud to provide you and your loved one with our highly-trained, professional in-home...
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Focus on Your Vision: Here at Bullkat Senior Protect we handle the complexities of senior care, allowing you to focus on your core vision. Leverage our expertise to unlock efficiency, innovation, and growth.
Cornerstone Caregiving is proud to serve West Cincinnati and its surrounding areas, offering exceptional in-home care services. Our caregivers take the time to get to know each client individually, providing personalized...
The Senior Helpers West Chester office was opened in 2018 to match the growing need for in-home senior care in the surrounding community. We offer a wide range of services from companion care to chronic disease care. We...
Easy Living Home Care is dedicated to offering reliable and compassionate services for individuals who need assistance at home. Whether it's helping with daily activities, providing companionship, or offering specialized...
Paul Tobillo, owner of Amada Senior Care Cincinnati, has made it his personal mission to help the seniors in our community live safer and more enjoyable lives. Says Paul, “To care and to receive care are the most...
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FirstLight Home Care of Greater Cincinnati is one of the most trusted home care and senior care providers in Cincinnati. We are proud to provide you and your loved one with our highly-trained, professional in-home...
Serene Platinum Home Care Services LLC was created with the belief that every individual deserves care that honors their dignity and independence. We are dedicated to delivering compassionate support that nurtures both...
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Home Matters Caregiving of Cincinnati, OH is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Precise Homecare provides dependable, detail-focused in-home support that helps clients stay safe, comfortable, and independent. Caregivers deliver personalized daily assistance with professionalism and compassion—giving...
Always Best Care combines national strength and standards with local accessibility and personal service. Your local Always Best Care team will be helping families throughout East Cincinnati and surrounding cities to...
Maxim Healthcare Services, Inc is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Judson Home Care is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
"touching lives through personalized home health care" Caring Hearts has been locally owned and operating since 1988. We operate on the principle of teamwork with the main goal to offer the highest quality of service...
Cardinal Home Healthcare Solutions, Inc is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Despite the best intentions, caring for an elderly loved one can quickly become overwhelming. At Home Helpers of Cincinnati and Northern Kentucky, we would be happy to discuss your present situation and provide you with...
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Visiting Nurse Association, The is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Parent Care Solutions is devoted to helping you care for your parents, grandparents, and loved ones in the comfort of their homes - or yours - for as long as they desire. We appreciate that the commitment to continue...
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Helping Hands Healthcare, Inc is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alternate Solutions Home Care of Cincinnati is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors Helping Seniors - Southeastern Hamilton County, OH is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or...
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Family Helping Families in Southwest Ohio & Northern Kentucky We Provide an Affordable and Caring Solution for the Busy FamilyTender Hearts At Home - Senior Care is the perfect solution for seniors and others who aren't...
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Senior Independence is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HomeWell Care Services of Cincinnati, OH is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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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.