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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:
Sure Harvest Home Health Care is a dedicated provider home care services based in Ohio. We specialize in delivering personalized and compassionate care to seniors
The Senior Helpers West Chester office was opened in 2018 to match the growing need for in-home senior care in the surrounding community. We offer a wide range of services from companion care to chronic disease care. We...
Blessed Hands Home Care LLC provides compassionate, non-medical in-home care for seniors and individuals with disabilities or mobility challenges. Focused on dignity, independence, and comfort, the company tailors each...
Home Matters Caregiving of Cincinnati, OH is a home care provider that services in Fairfield, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Queen City Elder Care, our owners and management team are Certified Dementia Practitioners and Trainers, providing expert dementia care and caregiver direction. We’re the only agency in the state with a Nationally...
Serene Platinum Home Care Services LLC was created with the belief that every individual deserves care that honors their dignity and independence. We are dedicated to delivering compassionate support that nurtures both...
Welcome to Liberty Home Care, where we are dedicated to enhancing lives and fostering independence. Our mission is to help individuals with physical and/or mental limitations maintain their lifestyle with dignity and...
Cornerstone Caregiving offers senior home care that allows your loved ones to stay in the comfort of their own home! Our services include Greater Cincinnati area including: Hamilton, Butler, Warren and Clermont Counties....
Cornerstone Caregiving is proud to serve West Cincinnati and its surrounding areas, offering exceptional in-home care services. Our caregivers take the time to get to know each client individually, providing personalized...
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead Senior Care® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance...
Seniors Helping Seniors - Fairfield, OH is a home care provider that services in Fairfield, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carobea Home Care Services offers compassionate, high-quality in-home care for individuals of all ages across Butler, Hamilton, Warren, and Clermont counties in Ohio. Specializing in senior care, post-hospital recovery,...
Compassionate Care Grace Mountain Home Health Care is dedicated to providing compassionate and personalized home health care services to our individuals to enhance their quality of life. Our team of professionals and...
At Matters of the Heart Homecare Our dedicated team of licensed RNs, LPNs, home health aides, and caregivers is here to provide a full range of personalized services tailored to meet the unique needs of each individual.
FirstLight Home Care of West Cincinnati, OH is a home care provider that services in Fairfield, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Based in Fairfield, Ohio, we provide free housing, food, clothing, legal help, parenting education, and family activities to struggling families. As the only full-service nonprofit in the area, we offer compassionate,...
Our Family Legacy LLC is a home care provider that services in Fairfield, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Preferred Home Health Care LLC, we offer Home Health Care. Our team members are educated, experienced, and compassionate too. We offer a less stressful, more affordable, and flexible option that families can take...
HomeWell Care Services of Cincinnati, OH is a home care provider that services in Fairfield, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SeniorCare Xpress services are designed primarily for seniors wishing to thrive independently in the comfort of their own homes. The principle around our programming involves a continuum of services that will enable...
DUP-Seniors Helping Seniors Fairfield, OH is a home care provider that services in Fairfield, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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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.