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:
If you or someone you love needs in-home care or assistance, give us a call at FirstLight Home Care. We provide quality, dependable in-home and elder care services for adults on Cleveland’s west side.
Eldorado Healthcare Management, LLC is a privately owned healthcare services provider based in Cleveland, Ohio. Established in 2017, the company specializes in delivering non-medical in-home support services, including...
LLS Homecare Services provides compassionate, professional in-home care designed to support independence, dignity, and peace of mind. Serving families throughout the Cleveland area, we deliver personalized care with the...
Cornerstone Caregiving is a senior home care provider in Cleveland, Ohio that is trained and ready to help your loved one today. Our leadership team holds decades of at home senior care expertise in the home care...
Kymco Reliable Home Care is dedicated to delivering dependable, compassionate, and personalized in-home support that helps individuals maintain comfort, independence, and dignity where it matters most—at home. With a...
Happy to Help Caregiving Services in Ohio is dedicated to providing compassionate and reliable non-medical care to seniors and individuals in need of daily support. Our caregivers offer personalized assistance that...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Senior Helpers of Greater Cleveland has been caring for seniors throughout Cleveland's West suburbs for over 10 years. We offer tailored services to meet the individual needs of your loved one. Our care services range...
A Caring Alternative Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Eldercare Services Institute Home Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alpine Home Health Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Providence Home Health Care, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Centric Care Services LLC is a Non-Medical Private Duty Home Care Agency; with the mission of being the most client centric home care service available to clients. Centric Care Services LLC is an independent...
Home Health Services of SW General Health Center is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Guardian Health Services, LLC is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mr Homecare Of Cleveland Ohio, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Just Like Familee Iii, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Chs of Greater Cleveland, LLC is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caregivers You Can Trust Feel better in the comfort of your own home. We specialize in care and daily living assistance to an array of individuals. Whether you need daily or weekly assistance due to aging, illness,...
Parma Community General Hospital Home Health is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seasons of Care Health Services, LLC is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Herrington Home Care, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors Helping Seniors is a non medical home care company. We provide a wide array of services such as companionship, meal prep, homemaker services, Alzheimer/Dementia care, 24/7, overnight care, yard work and handyman...
Personal Home Health Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Arcadia Home Care & Staffing is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Legacy Home Care, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Classic Medical Staffing is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nationwide Healthcare, LLC is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Xcel Healthcare Providers, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
McCray's Staffing LLC is a private home care assistance company that provides quality in-home care to those in need. We are also certified for MRDD clients for home in home care.. All Services are performed by State...
In Good Hands Care - Cleveland, OH is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Eagle Home Healthcare is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A 1 Nursing Care of Cleveland is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Fraternal Health Care, Llc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
University Hospital Home Care Services, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Assisting Hands Home Care® grew out of a desire to provide seniors, and others needing non-medical assistance at home, with the option that most people prefer – to remain independent, safe and comfortable in their own...
Visiting Nurse Association of Cleveland is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Horizon Health Services, Llc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Arcadia Health Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Mission and Values “As a member of The Senior’s Choice, a leading companion care service provider, our mission is to ensure a better quality of life for our elderly clients and the families by providing...
Imani Home Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Just Like Family Home Care, Llc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior care services from Home Instead® help to enhance the aging experience by providing practical support at home with a human touch. Our professional CAREGiversSM immerse themselves into wherever home is to assist with...
Big Heart Home Health Care LLC is focused on providing high-quality service and customer satisfaction - we will do everything we can to meet your expectations. We provide service in Cleveland, Youngstown, Ashtabula,...
Medicaid/Medicare certified Home Health Agency located in Cleveland and serving the needs of patients in the Greater Cleveland area and surrounding counties. All our employees undergo a background investigation process...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
At Senior Helpers, we are here to help anyway we can, no matter how big or how small the request. Our owners are the husband and wife team of Michael and Lynn Jones. Our team knows these aren't just clients, but cherished...
At BrightStar Care Cuyahoga West, we believe that caring is more than just a job– it’s a way of life. That’s why our caregivers mean so much more to the people, families, and organizations they serve.
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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.