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.
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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:
ARF is a national provider of home care and staffing services with over 30 years of experience and dedication to enhancing quality of life for others. We are proud of our compassionate home care program designed to...
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Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
Nu Care is the perfect solution for seniors and others in need who are not ready to leave their home for an institutional setting, but need support to remain at home. We improve your life by providing compassionate,...
Recently Awarded The Top 100 Leader in Experience with the highest Overall Satisfaction (OSAT) scores. We are #1 in Fresno and Kern Counties, and #2 Across the United States.
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Perfect Fit Home Care is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Every Northwest Valley family faces the challenges of caring for a senior family member differently. No matter the circumstance, the right caregiver can give you and your family respite while helping your loved one enjoy...
The Amada Senior Care team in San Fernando Valley is dedicated to going beyond basic home-care by gaining a deep understanding of clients and their individual needs so that they can make a truly positive impact on their...
ComForCare Home Care in San Fernando Valley is a premier provider of non-medical, private duty home care services. We assist people with the activities of daily living in any setting, whether it be a private residence,...
Founded in 2020 by industry veterans. After 16 years of combined home care nursing experience across different aspects of the home care field, Prestige Home Care Angels' founders decided to start their own home care...
Receiving care at home can often be more comfortable and less expensive compared to other types of care. Home Care Partner is dedicated to helping your loved ones get the care they need within their in-home.
All About Caring provides caring and support services tailored to each individual’s needs. I’m Patty Tierney, President of All About Caring and I’ve been a caregiver for 13 years. Mrs. Goddard, a lady that I’ve cared for...
Aim Home Care, Inc is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Trusted Caregivers our number one priority is to provide quality in-home care. However, in order to match them with the most compatible caretaker, we provide a free in-home assessment to better understand the needs of...
24 Hour Home Care - Encino is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Harmona Home Care, Inc. is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Golden TLC Plus Corp is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We Are Family Owned & Operated We are family owned and make sure to treat each client like family. We are passionate about what we do, and do everything we can to ensure the happiness and well-being of you and your...
Excellent IN-Home Care, Inc is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SANA CAREGIVERS, where compassionate care meets the comfort of home. We understand the importance of maintaining independence and dignity while receiving the support you need. Our team of dedicated caregivers is here to...
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All Med Home Health Srvs is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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It is our mission to provide quality, reliable compassionate and affordable care to our clients. We understand that the vulnerability of the frail, elderly, or disabled individual requires the presence of a caregiver who...
Care Sharing Home Hlth Agency is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OI IN HOME CARE SERVICES, INC. is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Accent on Home Care is your family's trusted companion and the leader in providing affordable personal in-home quality care and services for seniors and disabled individuals in the Greater Los Angeles Area. Services are...
Annex Healthcare Providers, Inc is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All Smiles Home Health Care, Inc is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
MATRIX CARE SERVICES, LLC is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homehealth Solution, Inc is a home care provider that services in Encino, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
At Amadeo In Home Care, we are passionate about enhancing the quality of life for individuals needing caregiving and companionship services. Our goal is to promote independence and well-being through personalized care...
The name of the game is RESPONSIBLE, being ACCOUNTABLE for the care we extend to our clients’, your loved one; is who we are and what we are. We morally ensure they are being taken cared of professionally. This we give...
At Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations as...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task, we at Senior Helpers South Valley are dedicated to the highest quality of care from day one. Slade Abisror, US Navy Veteran...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
At Home Helpers we work with seniors that have reached the point in their lives where they need and deserve help to continue living independently at home or in a senior community. This help might include preparing meals,...
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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.