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:
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Elsmar Home Health Care LLC of Detroit, MI is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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At Charity Home Care Services, we pride ourselves on being one of the most trusted providers of customized in-home care services. Charity Home Care Service offers personalized, non-medical care services. We help older...
Cha-Rae’s Care in Detroit, MI is dedicated to providing compassionate, reliable, and personalized home care services that promote comfort, dignity, and independence. Our caregivers support clients with daily living...
Alpha Home Care Services, Inc is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Plus Care LLC is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to our Care Giver and Patient Care Network in Detroit, MI. We are committed to providing compassionate, professional, and personalized care to individuals in need of assistance, whether it's for short-term...
Elsmar Home Health Care, LLC is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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DETROIT UNITED VILLAGE is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Bailey's Home Care Solution, we believe that everyone deserves to age with dignity, independence, and the comfort of home. We provide personalized, high-quality in-home care services for seniors and individuals with...
Elena Hearts of Bless Hands, LLC is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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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.
BATTLEFIELD HELPING HANDS is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Basic Home Help Care, Llc is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Almas Loving Hands Home Care, we understand that every individual deserves to age gracefully in the comfort of their own home. Based in metropolitan area of Detroit Michigan our dedicated team is here to provide...
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Allied Home Health Care & Nursing Services, L L C is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Champion Nursing Care, Inc is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All State Home Care, Inc is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ATTENTIVE HEARTS HOME CARE is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ethels Angels LLC of Detroit, MI is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Chs of Greater Detroit, LLC is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Abundant Creation Services LLC is a non-medical company that provides Senior Home Care Assistance. Abundant Creation Services works directly with the family to create an individual care plan that mirrors the family's...
Charlie's Abundant Home Health Care Agency provides valuable care services at the comfort of your own home. Offering competitive rates and passionate caregivers is our mission.
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Cardinal is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Accordia Senior Services In Home Care is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Covenant Connections Home Care, L L C is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tailored In-Home Care Solutions: Your Partner in Well-Being" At our Care Agency, we understand that every individual is unique, with their own set of needs, preferences, and aspirations. That's why we offer...
Bilquis Home Health Care LLC is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
B&b Loving Hands is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Affinity emphasizes a warm, empathetic approach that respects each person's autonomy. Their caregivers aim to build lasting relationships and provide just the right level of support to help clients thrive in familiar,...
Advanced Seniors Healthcare Group, Inc is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care With Greatness LLC is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comfort Care Home Care Assistance - Grosse Pointe is a home care provider that services in Detroit, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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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.