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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
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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:
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...
We believe that care should feel like home — warm, personal, and grounded in love. Our Family-Style Live-In Non-Medical Care offers compassionate, around-the-clock support for seniors and individuals who need assistance...
At Kindred at Home, our Personal Home Care Assistance can assist with personal care, daily living necessities, and help around the home. If you or a loved one is struggling with prolonged illness, recovery from surgery,...
WelbeHealth is a Program of All-Inclusive Care for the Elderly (PACE), full-service healthcare provider that helps you live your life healthy and happy, in your own home.
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Care Central Professionals provides dependable, professional in-home care and caregiver staffing to support comfort, safety, and independence. Their caregivers deliver personalized daily assistance and compassionate...
Anabelle`s In-Home Care is a home care provider that services in Elk Grove, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
California CareGivers - ACASA is a home care provider that services in Elk Grove, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
Integrity Care & Staffing of Elk Grove, CA is a home care provider that services in Elk Grove, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home was founded by Allen Hager. For many years, Allen worked in health care as a hospital administrator. While in the hospital environment, he watched patients – especially seniors – leave the facility and...
YOUR HOME ASSISTANT is transforming the home care industry. We have created an easy, affordable solution for those who need an extra pair of hands for what they need and when they need it. Our services are for all ages...
Moore Abundant Home Care LLC is a home care provider that services in Elk Grove, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
About Us Aging Assistant provides non-medical in-home personal care, companionship and assistance to seniors. We provide care for as little as 4 hrs/day or 24/7 live-in care for older adults. It is the most logical way...
Our mission is to enhance the quality of life for our clients by providing professional and reliable care in the comfort of their own homes. We offer a wide range of services, including assistance with daily living...
Golden Years In-Home Senior Care is a home care provider that services in Elk Grove, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Nurse Next Door, we go beyond home care. We believe seniors should have choice in everything they do. We match you or your loved one with the perfect caregiver, with care tailored to fit individual needs. We also...
Oceanview Senior Care is a home care provider that services in Elk Grove, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Country Home Care is a home care provider that services in Elk Grove, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aging Assistant’s mission is to provide superior service with the same care, concern and compassion that we would provide to our own families. We have over 14 years of caregiving experience with seniors and we are...
Our BrightStar Care team is available to help you and your family 24 hours a day, 7 days a week. We bring our quality home care services to these and other local communities.
Loving Companions is committed to helping seniors of our community age gracefully in the comforts of their own homes with dignity, security, and social connections. We provide respite for families or primary caregivers...
FirstLight Home Care of Elk Grove, CA is a home care provider that services in Elk Grove, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tailored In-Home Care Designed for Families Who Expect More Because Your Loved One Deserves Nothing Less Your care experience is inspired by our signature client journey, emotional mapping, and concierge-level service...
YOUR HOME ASSISTANT, LLC is transforming the home care industry. We have created an easy, affordable solution for those who need an extra pair of hands for what they need and when they need it. Our services are for all...
ASSURED CARE truly stands by its name. With over 20 years of experience, our agency thrives on being a Leader at Providing Quality and Exceptional In-Home Care Services to our Senior and Elderly Communities. With the...
ABOUT COMFORT CARE AGENCY We provides in-home care to seniors and other clients who need help with the activities of daily living (ADL). Our aim is to enrich the lives of our clients as we encourage them to maintain the...
Your Home Assistant, LLC is a home care provider that services in Elk Grove, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ally Independence focuses on the senior members of the greater Sacramento community being able to age gracefully during, what should be, their golden years. At Ally Independence, only the best candidates qualify to...
Home care has never been more convenient than with FirstLight Home Care. If you or an adult you love are in need of home care services, count on FirstLight to be there. Our friendly and highly trained staff offers home...
Golden Years In-Home Senior Care is an innovative leader in the area of non-medical in home care. Our specialized care covers a wide range of services that relate to supporting and maintaining a happy healthy and safe...
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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.