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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:
At Senior Helpers of MetroWest, we are here to help anyway we can. No matter how big or how small the task. We our licensed, bonded and insured and have screened and continuously trained caregivers that are immediately...
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...
Alta Homecare provides compassionate, non-medical in-home support to seniors and adults throughout Middlesex County, MA. Our dedicated caregivers assist with personal care, companionship, meal preparation, and daily...
Celebrating life, dignity and independence.® Since 1984, the founders of Preferred Care at Home have had the privilege of assisting clients improve their quality of life while still recognizing and maintaining their...
HomeWell Care Services of MetroWest, MA is a home care provider that services in Framingham, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Always Best Care combines national strength and standards with local accessibility and personal service. Your local Always Best Care team will be helping families throughout Worcester and surrounding communities providing...
Robert and Daniel Appel, owners of Amada Senior Care Boston MetroWest, know from personal experience the difference quality care can make in the lives of seniors and their families. Says Robert, “Now, having seen how big...
Quality Private Home Care Services is a trusted and compassionate home care agency dedicated to enhancing the lives of individuals in need of personalized assistance.
At Homily Care Agency, we offer a wide range of health care services for disabled and elderly individuals in the comfort of their own homes. Our dedicated team ensures that our clients receive the best care and attention...
We are a recognized agency providing Home Health Care wherever a client lives in Eastern Massachusetts. We are also Alzheimer's specialists. The service can be a few hours or 24 hours. We offer Live-in, hourly,...
At Amazing Caregivers we have exceptional caregivers who provide high-quality care and support for individuals with various needs, including elderly adults, those with chronic conditions, and individuals with...
Sunlight Care LLC is a home care provider that services in Framingham, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Quality Care... Signature Home Care provides high quality, dependable personal care services to all individuals regardless of race, religion or ethnic background. Often individuals recuperating at home or suffering...
Advanced Home Care Services is a home care provider that services in Framingham, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
There is no secret why I chose to lead Sudbury River Home Care….It was my calling. I wasn’t a mean kid, but I did seem to get into a lot of trouble when I was in high school. Days before my senior year began, I was...
Independence Home Care, Inc. was founded in order to provide non-medical senior home care services to the eastern Massachusetts region, and maintains locations in Boston, MA, Burlington, MA, Framingham, MA, and Duxbury,...
Medical Professional Staffing & Family Home Care is a home care provider that services in Framingham, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Metrowest Homecare is a home care provider that services in Framingham, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advanced Home Care Services of MA is a home care provider that services in Framingham, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It is our vision to be the best support system that eases pain for families going through the challenges of caring for their declining loved ones. We also work to facilitate opportunities for compassionate caregivers...
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance the quality...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Framingham, MA. 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.