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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:
Healing Haven Home Care stands out from the rest through our unwavering commitment to personalized care and holistic well-being. We take pride in seeing you as a whole person, not just a customer. We believe in treating...
LCH PHC is dedicated to helping you or your loved ones stay safe and independent in the comfort of familiar surroundings. Our in-home care services are tailored to support individuals facing a variety of health challenges...
Welcome A little help could go a long way. We understand, and we are here to help with reliability, professionalism, and kindness. We send trained aides to the homes of our clients to provide support with activities of...
At Careco - The Caregiving Company, we are committed to providing high-quality non-medical in-home care services tailored to the individual needs of each client. Our mission is rooted in compassion, respect, and...
Whether providing short-term assistance or long-term support, our team is committed to enhancing well-being and fostering peace of mind for both clients and their families.
Kimberly Cotto, owner of Amada Senior Care in Southwest Atlanta, knows firsthand the impact that accessible healthcare and quality care services can make. As a breast cancer survivor, Kimberly has spent her career...
Charlotte Web Private Home Care, LLC is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
LEGACY CARE STAFFING is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ROSA'S HOME CARE SOLUTIONS is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TREES OF LIFE HOMECARE, LLC is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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.
Happy Home Care Agency provides compassionate, personalized in-home care services. We support seniors and individuals with disabilities through skilled caregivers and tailored care plans, prioritizing comfort, dignity,...
GOLDEN RULE HOME CARE LLC is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Solutions is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Loving Hands Serenity Healthcare Services LLC is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
duplicate - Home Helpers Home Care of Ellenwood, GA is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
GOOD LIVING HOME CARE LLC is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DOROTHY'S ANGELS HEALTHCARE, LLC is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CHOSEN HEALTHCARE SERVICES, LLC is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sharon Health Services LLC, PA is a home care provider that services in Ellenwood, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Pennie's Home Health Care, Compassionate In-Home Care Services At Pennie's Home Health Care, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
Our goal at Nobility Home Care Services is to provide private in‐home skilled and companion services that are professional, demonstrate respect and operate with confidentiality and consideration for our clients. We intend...
FirstLight Home Care delivers loving and compassionate care to seniors in Atlanta in the comfort of their own home. Our team's "Culture of Care" helps people age independently with confidence, dignity and happiness.
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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.