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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:
Through personal care plans with Comforcare Home Care services, our office can determine the best plan of individual care based on your families specific needs. Our dedicated caregivers can be available for as little as a...
Reliable Homecare Angels is a home care provider that services in Devon, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When you and a loved one in your life require care assistance, Executive Home Care is ready to lend a hand. Find out more about the expert and compassionate senior living care that is offered in the comfort of one’s own...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
Cornerstone Caregiving proudly serves Berwyn, the Main Line, and Chester County with compassionate, reliable, and personalized in-home care. Our mission is to help seniors and individuals maintain independence, dignity,...
Right Now Home Care is a home care provider based in Philadelphia, Pennsylvania. We understand that every client has a different care plan they need for their individual lives. Our daily services include meal preparation,...
At Options for Senior America, we believe aging should never mean giving up independence or dignity. Our Wayne, Pennsylvania team is dedicated to providing high-quality, personalized in-home care that allows seniors to...
Qualicare is your family’s partner for personalized home care. Whether the need for home care has been growing over time or your loved one’s circumstances have changed overnight, you’ve got difficult decisions to make,...
Home Instead - West Chester, PA is a home care provider that services in Devon, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of W. Montgomery Co. offers in-home care and medical staffing that goes above and beyond. We call it “A higher standard." Our Professional Care Team, led by a Registered Nurse Director of Nursing,...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
The entire professional care team at Amada Senior Care Philadelphia West Suburbs understands the importance of quality senior care that helps aging adults thrive and live safely and independently. Choosing the right home...
Formosity Support Services, LLC is a non-medical home health agency with over 10 years of experience providing compassionate and reliable care. They are dedicated to helping seniors and individuals with disabilities live...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Caring for older adults is our passion and specialty, serving older adults for over 20 years! NursePartners is founded, owned, and operated by Angela Geiger, Registered Nurse and Certified Dementia Practitioner. We...
As we age, we will eventually reach that point where we only have little control over our mobility, our health and many other life circumstances that are tied with old age. Similarly, we experience these struggles when we...
Strafford Registry is a locally owned Home Care Agency based in Devon, PA. We provide medical and non-medical in-home care services to the Main Line and surrounding area. We also supply medical staff to local nursing...
Nurse BankAmerica is a home care provider that services in Devon, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angel Companions offers a variety of senior in-home care solutions, including services for a few hours a day or around the clock live-in care. We help seniors needing assistance with the activities of daily living, people...
Welcome to Holy Guardian, your trusted partner in home care. We understand that everyone has unique needs, which is why we offer personalized care solutions to help you or your loved one live safely and comfortably at home.
Liberty In Home Care provides convenient and high quality in-home care for seniors in SE Pennsylvania, including Philadelphia, Chester County, Delaware County, and the Main Line. We specialize in helping your loved ones...
Why I founded Angel Companions In-Home Care for Seniors - Years ago, my wife Robin and I were faced with multiple family health issues that required us to seek outside help. Between our son’s battle with a debilitating...
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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.