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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:
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Right at Home is North Atlanta's trusted quality in-home senior care provider. We create custom care plans as needs change to allow your family members to live at home as long as possible.
L and W Legacy Home Care, Compassionate In-Home Care Services At L and W Legacy Home Care, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We our licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
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...
BrightHeart Homecare Inc. is a dedicated home care agency committed to providing compassionate, high-quality, and personalized care for seniors and individuals in need of assistance.
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...
Edgewater Medical provides compassionate, high-quality healthcare and in-home support services for seniors and individuals with disabilities. Our dedicated team assists with daily living, medical care, and companionship,...
At Senior 911, we believe that we must provide excellent senior care and that every person we encounter is treated with dignity, kindness, and respect. We provide families with peace of mind that their loved one is safe...
Charlotte Web Private Home Care, LLC is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Right Hand Care, we believe that support should feel like a helping hand, not a burden. Our dedicated caregivers provide respectful, personalized care to help clients stay independent, safe, and comfortable in their...
Acti-Kare of Canton, GA is a leading in-home senior care company that has been trusted for over a decade. Our caregivers are insured, bonded, and trained which means you will receive a trusted and professional caregiver...
Seniors Helping Seniors® In-Home Care Services matches seniors who need a hand with mature, active women and men who have a passion for helping others. Seniors Helping Seniors® in-home services was founded in 1998 with...
SYNERGY HomeCare of North Atlanta, GA is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When life's events- aging, illness, or disability make living at home more difficult Assisting Hands Home Care understands. Our dependable caregivers offer the very finest personalized non-medical care including...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
QUALITY FAMILY CARE SERVICE LLC is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CAREBRIDGE COMPANIONSHIP LLC is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Healthfield Home Health of Atlanta is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Duplicate - Assisting Hands Home Care of Forsyth, GA is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Stay at Home of NE Georgia provides compassionate, dependable and loving care for the elderly, ill and disabled in the comfort of their own home or wherever they may reside. Our services create an environment that...
BrightStar Care, Local entrepreneurs Stacey and Steve Voshall are fulfilling their dream of making a difference in the lives of residents in Gainesville by opening a BrightStar Care homecare franchise agency. This new...
PaShence Home Care is a local non-medical home care agency that was built on integrity, love, kindness, and compassion. We are fully committed to being involved in the care of your loved one by providing the services...
Southern Companions, Cumming is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
United Home Care of Cumming is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DEVOTED SENIOR CARE LLC is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
LOVING HEALTHCARE SERVICES LLC is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HM Care Services LLC is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Areas We Service in Cumming & Gainesville BrightStar Care of Cumming & Gainesville, GA is available to help you and your family 24 hours a day, 7 days a week. We bring our quality home health care services to these and...
Care Place Inc is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ROYAL FAITH HOMECARE AGENCY LLC is a home care provider that services in Cumming, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Vidma care mission services provide a wide range of assistance with day-to-day tasks that help seniors continue living their independent lifestyle. We understand that in-home senior care is not a “one size fits all”...
In Sricare we distinguish ourselves through our commitment to personalized care and respect for each client's unique needs. Our caregivers are dedicated to tailoring their services to provide the highest standard of...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
At Home Matters Caregiving of North Atlanta, we provide homecare that strives to keep our clients as independent as possible; improving quality of life, longevity and provide peace of mind.
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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.