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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:
ATLANTA ONE STOP THERAPY is a unique and powerful healthcare practice serving adults and children where the focus is to develop a customized treatment plan for each of our clients.
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.
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
At Amada Senior Care Atlanta, we constantly look for ways to bring enjoyment to clients’ lives by making even the most common tasks and activities special. Our in-home caregivers form close bonds with clients as well as...
Just as growing older can allow for a more relaxed lifestyle, it can also present new obstacles and challenges. Our clients have peace of mind knowing that we are dedicated to their satisfaction and quality of life. We...
When seeking a care service for seniors, those with disabilities, illness or recovering from injury or surgery, there are many factors to consider. You undoubtedly have many concerns and reservations. This is perfectly...
Alpha Comfort Care Inc offers home care services to help seniors or other people with disabilities, injuries, and illnesses stay or spend their healing process in the comfort of their homes instead of residing in nursing...
Senior Solutions is a non-medical comprehensive home care agency that trains caregivers who assist our clients with activities of daily living in their own homes. In recent years, we have also added service lines to help...
At Care For You by Us, we understand that the need for personal care can arise at any point in life. From seniors who require assistance with daily tasks to individuals recovering from surgery or illness, we are here to...
GRISWOLD SPECIAL CARE The World’s Oldest Multinational Non-medical Homecare Company Trusted Homecare at Affordable Rates GRISWOLD SPECIAL CARE refers Caregivers who provide companionship, homemaking, and personal...
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...
If you’ve been searching for a quality home care agency, either for yourself or a loved one’s care, then you’ve likely discovered a “sea of sameness” in the dozens of home care choices available. We know that it can be...
Our services include assistance with daily living activities such as bathing, dressing, grooming, and mobility support. We also offer medication reminders, light housekeeping, meal preparation, and laundry services to...
Charlotte Web Private Home Care, LLC is a home care provider that services in Dunwoody, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Since 2002, Senior Helpers has been a national leader in professional in-home care services. With a vision to help seniors remain in their homes despite age-related changes and chronic medical conditions, we have now...
For 24 years, TheKey has earned the trust of more than 120,000 clients by delivering 12 million hours of personalized home care each year using our science-backed Balanced Care Method® that actively supports well-being....
Home care services help individuals maintain their independence in a safe, familiar place. Our trained in-home caregivers assist with day-to-day tasks, build strong bonds, and make sure friends and family are aware of...
LovingU Personal Care LLC is a compassionate home care agency dedicated to providing personalized, non-medical support to seniors and individuals in need within the comfort of their own homes. Our trained caregivers...
Our Mission Our mission is to enhance the well-being of our clients by delivering the highest standard of personalized, home-based health care. We strive to create a supportive environment where clients can feel safe,...
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.
At Regency Home Care of North Atlanta, there is no higher priority than the health and safety of our clients. When a loved one requires extra care and assistance, turn to Regency’s certified expert care staff, because...
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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.