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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:
Home Care Team of Texas LLC provides compassionate, personalized non-medical care to seniors and individuals who need support with daily living. Our experienced caregivers are dedicated to promoting independence, safety,...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Tomball or in surrounding areas.
Happier at Home is the perfect solution for seniors that need support to maintain independence in their place of residence, no matter where they call home. We are dedicated to improving the lives of our clients by...
Well At Home, Home Health provides compassionate, professional in-home care designed to help individuals live safely and comfortably in their own homes. Our skilled caregivers and nurses deliver personalized support that...
Azaria's Home Assistant Agency is committed to providing compassionate, trained caregivers who deliver individualized care plans in Houston, enhancing comfort and independence for our clients in need.
At Home Matters, we’ve made it our mission to provide high quality care for seniors that allow our clients to remain safe, comfortable, and independent at home. Our approach is unique, based on years of research in the...
Why do people need in-home care? Perhaps an elderly loved one needs help doing chores around the house or running errands, or maybe a degenerative disease like ALS or dementia has made it difficult for them to complete...
We take pride in serving Cypress, TX and its surrounding areas. Our dedicated caregivers not only provide exceptional in-home care services, but also create meaningful connections by learning their preferences and...
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...
Appointed Time Health Care delivers timely, compassionate in-home support that helps clients stay safe, comfortable, and independent. Their caregivers provide reliable daily assistance tailored to each person’s...
Senior Helpers of North Houston advocates for high-quality senior care. We deliver customized, dependable, and affordable care to help provide a high quality life for our clients and their families.
At allaround Care, our mission is simple yet profound: to provide dependable support and caring service in a family atmosphere. We believe that every individual deserves to age with dignity and independence within the...
It doesn’t matter if you’re here because you’re looking for help living independently, or if you want to make sure someone you love has the support they need to stay in their home. Right at Home Houston believes there’s...
Home Helpers® Home Care is a home healthcare service that provides top quality in-home care. Our Cared-4℠ program is a holistic approach to meet the four primary areas of need, helping your loved one stay safe and...
At Embracing Hearts In-Home Care, we believe true care begins with compassion. Our devoted caregivers deliver personalized support—from daily routines to heartfelt companionship and specialized assistance—helping clients...
Mission At Harbor Home Care, our mission is to provide compassionate, high-quality home care services that enhance the well-being and independence of our clients. We are committed to delivering personalized care that...
Oceanside Health Services llc was created by a devoted Registered Nurse whose greatest passion is helping people feel better and live healthier lives. Guided by compassion and clinical expertise, we deliver exceptional,...
We are a home care agency that is dedicated to delivering exceptional quality care and making sure all of your loved one's safety and personal care needs are met. Home Care for the 21st Century is not only forward...
IN HOME CAREGIVERS OF CYPRESS LLC is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Affectionate Healthcare LLC is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
"We treat you royally around the clock" The staff at Queen's Care In Home 2 look forward to getting to know you and your family. Our desire is to help you acheive optimal health. We are here to provide comfort and...
Acti-Kare of Cypress, TX is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
La La Comfort Health is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our in-home senior care option allows seniors to lead safe and independent lives in the comfort of their own homes. When family members of a senior need support to care for their loved one, A Place At Home – Cypress steps...
Altima Healthcare Services Inc is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At AFT Healthcare, we understand the health challenges that both children and adults face. We believe every individual deserves access to high-quality health care services, which is why we offer a wide range of...
Divine Hands Healthcare Corporation is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
EXQUISITE QUEENS INHOME CARE is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ceregen Health LLC is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At HomeWell of Cypress we provide hourly home care for seniors and others who are struggling to manage day-to-day activities like grooming, bathing, cooking, or even running errands. Our knowledgeable Care Managers and...
Elife Home Care is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
WELLSTEAD HOME CARE SERVICES LLC is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Giving Care Houston, LLC is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mountain Springs Home Care LLC is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carewatch Home Care LLC of Cypress, TX is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Select Care Home Health Inc is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Victoba HealthCare Services Inc is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AC Competent Providers Inc is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Personal Help Unlimited LLC is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our in-home care services brighten the lives of seniors who can benefit from a helping hand & a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing compassionate care in the...
HEALING QUEST HOME CARE LLC is a home care provider that services in Cypress, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Life is Better with Villi of Houston, TX At Villi, we believe “It takes a village,” and we’re here to be that village for you and your loved ones. Our mission is to bring comfort, joy, and a helping hand to your daily...
Caring Homes of Serenity, LLC offers : Companion Care Doctor Visits Errands/Shopping Help with Eating Laundry Light Exercise Meal Preparation Medication Reminders Respite Care Socialization/Emotional Support...
Synergy HomeCare of Katy provides certified caregivers and personalized care for seniors living with cognitive or physical limitations. We are an affordable, compassionate and respected home care choice for families who...
Bright Autumn Home Care stands at the heart of service, with a special focus on compassionate, tailored support for our seniors. We give seniors the opportunity to live life on their own terms, aging with dignity, grace,...
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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.