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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.
✔
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:
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We have passionate and professional caregivers ready to provide in-home senior care. Please contact us if you or your loved one needs care services in the DFW Northwest area.
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We Provide Care That Keeps You Safe at Home When a loved one becomes weak, recovering from illness, or at risk for falls, home can suddenly feel unsafe and overwhelming.
Senior Care Transitions, LLC is a home care provider that services in Coppell, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Seniors Helping Seniors - Grapevile, Keller and Denton our in-home care feels less like a service and more like getting a little help from your friends®. Our caregivers are compassionate fellow seniors who are...
Mal & Mal Home Health delivers compassionate, reliable in-home care that supports comfort, safety, and independence. Caregivers provide personalized daily assistance and meaningful companionship—giving families peace of...
FirstLight Home Care of Flower Mound provides personalized in-home care services to seniors, veterans, individuals with disabilities and adults recovering from illness or injury in Flower Mound, Lewisville, Carrollton,...
Our mission at Home Care Assistance is to change the way the world ages. We provide older adults with quality care that enable them to live happier, healthier lives at home. Our services are distinguished by the caliber...
Assisting Hands Home Care provides professional non-medical home health care services, allowing our clients to remain safely and comfortably in their own homes.
Mint Care LLC is a client-centered care organization dedicated to providing compassionate, reliable, and high-quality support services tailored to meet individual needs.
At CHRISTY GRACE HEALTH CENTER INC, we focus on providing the highest standards of clinical care with compassion. We offer a variety of comprehensive healthcare services in the comfort of our clients’ homes. We provide...
Christus Homecare is a home care provider that services in Coppell, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comfort Home Health Care is a home care provider that services in Coppell, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
There comes a time when many families realize they need additional help in caring for their loved ones. Senior Care of North Texas is here to assist as a partner in life's challenges. As a locally owned business, we offer...
We are committed to providing compassionate, personalized, and high-quality care to our clients. We believe that everyone deserves to live a happy, healthy, and independent life, and we strive to support our clients in...
Suitable Homehealth Care Inc is a home care provider that services in Coppell, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
J Jireh Healthcare Services Llc is a home care provider that services in Coppell, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aster Home Healthcare Llc is a home care provider that services in Coppell, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carevora Inc is a home care provider that services in Coppell, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Trusted care means peace of mind. Taking that first step in finding a home care provider can be a stressful decision. With HomeWell Care Services, you know you’re making the right decision.
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...
Senior Helpers of Richardson offers companion care, personal care, and chronic disease care to seniors in the Greater Dallas area. We help you to decide what care service is best for your loved one and family 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.