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:
Elevé Home Care offers compassionate, physician-informed in-home care designed to support comfort, dignity, and independence. With personalized care plans, assistance with daily activities, companionship, and wellness...
E&M Home Health Care LLC is a trusted provider of home health care services committed to enhancing the well-being and independence of our clients. With a focus on personalized care and attention to detail, we strive to...
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...
Our philosophy at Wise Home Care is to provide the quality of care that we would want for our loved ones. Home care is a sincere appreciation of and for the people we serve. We invite you to call us to discuss how Wise...
Altus home support provides dependable, compassionate in-home care that helps clients stay safe, comfortable, and independent. Their caregivers deliver respectful support tailored to each individual’s daily needs —...
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...
Summit Home Care is a skilled and non-skilled home health care agency committed to providing comprehensive health care and comfort and convenience of home. Our mission is to positively impact the quality of life by...
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...
Acti-Kare of Northwest Columbus, OH provides tier one in-home Personal care. Our trained, insured, and bonded caregivers will provide your loved one with in-home personal care services across a broad range of categories....
At Golden Age Home Health Care, we believe that compassionate care is the cornerstone of a meaningful life. As a trusted provider of home health services, we specialize in delivering personalized, high-quality support...
Seniors Helping Seniors® in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing...
Whether you need in-home support a few hours per week or multiple hours every day, we can help. Whether you want in-home aide services for a week or from now on, we'll be at your side. We serve you on the schedule that...
Our team at Sympatico Healthcare Solutions is composed of qualified and trained professionals who possess the necessary skills and knowledge in providing holistic care. They are dedicated to helping improve the quality of...
Since 1898, LifeCare Alliance has been there for people facing challenges that stem from medical conditions, disabilities, or aging in place. Each year, LifeCare Alliance serves over 21,000 Central Ohioans in their homes...
Ray and Lisa are owners of HomeWell Senior Care of Central Ohio. When they discovered that they could own a business that helped seniors age gracefully and with dignity, they knew this was exactly what they wanted to do!...
Continental Home Health Care, Inc is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Accessible Home Health Care of Columbus is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Hearts Home Health Services, Inc is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Diversified Home Medicals, Inc is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Health Care Plus is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DL Home Care Solutions is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carepartners Home Health, Inc is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Embrace Home Health Care, LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Generations Healthcare Services, LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heartland Home Health Care Inc is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advanced Home Care Inc is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Able Support Services, Inc is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
American Nursing Care Columbus is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amberstar Home Health LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Affordable Home Health Care Services, LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amazing Health Services, LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bridge of Light Health Services, LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Americare Healthcare Services, LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A M Friends & Family Healthcare, LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ebe Healthcare, LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Healthpro Home Care is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ambassador Home Health Services is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Healthy Solutions Home Health Services is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Harmony Home Health Services is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Excel Health Services is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ABC Home Care and Nursing Services is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Community United, Inc is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Best Nursing Care, Inc is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Kean Dillon opened the Senior Helpers Columbus office to provide high quality in-home senior care in the community of Westerville and surrounding areas. Senior Helpers strives to treat clients with the same warmth,...
services of Amada senior care - in home senior care services At Amada, quality care is our priority. We look for ways to make simple, everyday tasks special. Amada’s in-home caregivers not only take care of daily...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home somewhere in Buckeye Nation. We service all of Columbus and its surrounding areas, including Marysville...
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...
Alta Home Health Care, LLC is a home care provider that services in Columbus, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Helping People through Home Care in Dublin, Ohio - Trusting someone to care for your elderly parent or loved one with disability other than your family, takes a lot of courage and willingness. Turning to FirstLight...
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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.