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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:
With Nissi Agency you can entrust your loved ones to our experienced management and dedicated staff, who will go above and beyond to ensure that your loved one receive the best care.
Our team of caregivers assists with age-related duties that grow increasingly challenging for those who prefer to stay in their homes. No other home care service in the region gives the same degree of individualized and...
To promote the seniors’ quality of life while uplifting their dignity and independence. For an optimal state of living, we strive to serve them in many ways we can.
At SENIOR HELPERS of Danbury, CT we are dedicated to supporting families in our community with personalized care, no matter how big or small the task. Our mission is simple: to keep your loved ones safe while maintaining...
There’s a reason why Unity Home Care LLC, is a leading provider of homecare in Farmington, Connecticut, and that’s simply because we truly care for you! Elderly, injured, ill, and the disabled—we make every high-quality...
Home Care Advantage is a family-owned and operated non-medical home care agency providing quality, compassionate care for seniors, and disabled adults. We specialize in Companion Care, Personal Care, 24-Hour Care, Live-In...
At Valeriana Home Care LLC our commitment is to transform the way in-home care is experienced—by blending compassion, excellence, and truly personalized support. Our mission is to help individuals live safely and...
HomeWell is committed to helping people live life more fully. With a highly personalized care management approach, we strive to provide the highest quality of care in the place where clients feel most comfortable.
At OurCare, we understand the importance of providing compassionate and personalized care for our elderly clients. With a team dedicated to enriching lives and fostering independence, we offer a range of services tailored...
Denise Lehman opened Senior Helpers of Central Fairfield County in April 2020. Denise is a strong advocate and passionate about enhancing the life of every one of her clients. The Central Fairfield County team looks...
At Family First Home Care Agency, we are dedicated to providing exceptional non-medical home care services that prioritize the well-being and independence of our clients. Our compassionate caregivers are committed to...
Regional Hospice of Western CT is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
True Vine home care is a registry that includes a staff of Licensed Practical Nurses, Certified Nurse Aides, Home health Aides, Personal Care Attendants and Live-Ins, all considered private contractors. True Vine Home...
Erica Thompson is a dedicated healthcare professional with over 16 years of experience as a registered nurse. Her extensive career has been marked by her passion for providing quality care and her commitment to improving...
At Happy Family Home Care, our clients are our only priority. We pledge to honor your trust by providing well trained and highly motivated professional care support, coupled with exemplary customer service. Our...
Elderly Caregivers Of Vermont is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
With dependable service, highly trained caregivers, and a deep dedication to compassionate care, Best In-Home Compassion Care is proud to be a trusted partner in helping individuals live life to its fullest—at home, where...
Connecticut Caregiver Connection (CCC) was formed by the same family owned agency that has been providing the highest quality caregivers in Fairfield County since 1930. CCC is dedicated to providing caregivers that are...
Danbury VNA Inc is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SYNERGY HomeCare of Danbury, CT is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Life is so much more than a to-do list. It's a series of moments with the people we love, making memories that make up a lifetime. BrightStar understands this, and is committed to making more of those moments possible in...
Elderly Caregivers is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SYNERGY HomeCare of Danbury, CT (NY Coverage) is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Victory Home Care Mission Statement Victory Home Care's mission is to help your loved ones maintain a comfortable, healthy, and independent living by providing non-medical support services through live-in and...
Care with Dignity is an independent and privately owned non-medical home care agency located in Danbury, Connecticut serving Fairfield county and Southwestern CT. Our agency is founded on the principles of caring for the...
Danbury Health Systems is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Avalon Homecare was founded in 2012, by Lucelle Thring, a C.T. Licensed Practical Nurse. The core principles learned from the nursing field are the same principles Avalon Homecare was founded on which are: compliance,...
The company specializes in offering personalized care plans for elderly individuals, with a focus on enhancing their quality of life and maintaining independence for as long as possible. Services typically include...
Sage Home Care - Danbury, CT is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right Pro Staffing, LLC is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Danbury, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Serenity Care At Home provide non-medical, companion and homemaking services for seniors in a variety of settings from private homes or senior living and care communities located throughout Connecticut. various medical...
Spending time with others is essential to a senior’s mental and emotional health. Keep your or a senior loved one’s mind engaged with meaningful social interaction from a dedicated companion. Seniors Helping Seniors®...
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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.