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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:
Through personal care plans with Comforcare Home Care services, our office can determine the best plan of individual care based on your families specific needs. Our dedicated caregivers can be available for as little as a...
Homewatch CareGivers of Pottstown delivers personalized in-home care services that preserve dignity, independence and safety for our clients. Our approach focuses on the whole person, not just their condition. When people...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Receptive Home Care is a leading provider of compassionate and professional in-home care services, dedicated to enhancing the quality of life for individuals who require assistance with daily activities.
Absolute Home Healthcare PA is dedicated to enhancing the quality of life for individuals and families in Southeastern Pennsylvania. We provide compassionate, personalized in-home care services to support those who need...
HomeWell Care Services of Norristown, PA is a home care provider that services in Collegeville, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Services. At 5karats of love we provide... In home care Personal care Non skilled care Monitor vital signs accompany doctor appointments Warm companionship Meal preparation Light...
At Amada Chester County, we strive to provide the highest quality of care with a sense of warmth, kindness and compassion. Each member of our team is committed to your loved one because to us, they are family. We take...
YourVision Home Care is more than an agency; it's a promise of compassionate support, fostering a sense of belonging, and enriching the lives of those we serve. With open hearts and skilled hands, we embark on this...
Vision Statement Our vision is to become the national leader in the home care industry, renowned for exceptional care, compassion, and professionalism. We aim to set the standard for outstanding service that...
As we strive to offer companionship and holistic support for our clients, Jovial Care Givers works to enhance the quality of life for your loved ones while providing reliable in-home non-medical care in Pennsylvania.
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...
Shell's Home Care will develop individualized care plans that are based on a patient’s specific needs. This ensures that every patient receives the right level of care at the right time.
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Fidelity Home Care is a trusted provider of compassionate, high-quality in-home care services for individuals in need of assistance with daily living activities. With a strong commitment to personalized care, Fidelity...
J-Ione Companion Care Agency is a trusted provider of compassionate, non-medical in-home care services for seniors and individuals with disabilities. Our dedicated caregivers offer personalized support with daily...
Home Matters of Philadelphia-- Montgomery County is a home care provider that services in Collegeville, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
LaBelle Home Care You can trust in your loved one’s health, happiness, and care thanks to our talented and compassionate caregivers. Our purpose is to serve you. It is our goal to provide our clients with optimal care...
EverGreen Care LLC is a home care provider that services in Collegeville, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Always Here 2 Help, Inc. is a home care provider that services in Collegeville, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HOME CHOICE COMPANION CARE PROVIDES OUTSTANDING NON MEDICAL COMPANION CARE TO SENIORS WHO WISH TO STAY IN THE COMFORT OF THEIR OWN HOME. OUR MAIN OFFICE IS IN COLLEGEVILLE PENNSYLVANIA HOWEVER WE HAVE NINE OTHER LOCATIONS...
For more than 10 years, Senior Helpers has been providing customized professional care services to seniors and families throughout the Pottstown area. To support aging in place, we provide a full variety of services...
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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.