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:
A Place at Home Allen is here to provide you with compassionate professionals to assist you or your loved ones throughout the aging process. We strive to provide seniors with the ability to age with dignity and respect...
One You Love Homecare provides senior in-home care services for your loved one. We pride ourselves on being one of the only homecare organizations that delivers what we like to call, “Always Caring Expertise.” Simply put,...
Our home care services can help aging adults stay engaged in everyday life with tailor-made support by professional caregivers to stay safe and well at home. It’s our mission to provide a care plan personalized to your...
At Home Helpers® Home Care, we want to be the extended family for your aging loved ones when you aren’t able to be there. It’s our mission to make life easier for our clients by providing the same exceptional care that we...
Life is Better with Villi of Dallas, TX At Villi, we believe “It takes a village,” and we’re here to be that village for you and your loved ones. Our mission is to bring comfort, joy, and a helping hand to your daily...
Our in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing compassionate care in the...
At A Better Solution In Home Care, we believe that aging, recovering, or living with a disability should never mean losing comfort, dignity, or independence. Founded with a deep commitment to compassionate service, we...
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...
Bent Schoellhorn opened the Senior Helpers Greater Dallas office in 2007 due to his commitment to delivering the best in-home care to seniors in the Greater Dallas community. Bent and his wife of 46 years consider it an...
Our experienced and professional caregivers provide the care and support you or your loved one need to remain living independently at home while providing peace of mind to the family caregiver.
Our vision is to be the most trusted home care agency in Dallas County, TX, recognized for excellence and genuine compassion. We aim to create a community where every senior receives personalized attention that celebrates...
Genuine Global Care is a top provider of in-home senior care. Our caregivers are highly trained and experienced in providing top-quality care. We provide a wide range of services, including companionship, personal care,...
Our path is simple- to make a difference to our clients while helping them achieve their best selves, providing best possible individualized care from people who truly care. We understand life has lots of journeys and...
At Mount Zion Home Care, we believe true care is built on compassion and purpose. Our caring team provides individualized assistance from everyday routines to meaningful companionship and specialized care empowering...
Right at Home Lewisville believes there is far more to caring for people than simply providing in-home assistance. You deserve a care partner who understands the journey ahead and will help you navigate every step....
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...
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...
Herewith, Inc. is a nationwide platform connecting families with caregivers for in-home non-medical assistance. In Texas, they offer flexible senior care services through a network of "Caregivers" who assist with tasks...
When it comes to choosing an in-home senior care provider in Prosper, we know that you have many choices. CareBuilders at Home’s commitment to client engagement and safety, innovation, and quality services sets us head...
Home Instead, Inc. began franchising in 1995. Today, the Home Instead® network has grown to include more than 1,200 franchises around the world. While our franchise network is international, our office is local. And to...
Acti-Kare is a leading in-home senior care company that has been trusted for over a decade. Our caregivers are insured, bonded, and trained which means you will receive a trusted and professional caregiver every time....
ALMAZ PERSONAL HOME CARE SERVICES LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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.
Nannas Homecare Inc is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BLUESKY HOME HEALTH SERVICES LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Favorite Home Health Care LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A LEGACY HOME CARE LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our in-home care services provide the daily support adults need to live a life of dignity with as much independence as possible in North Dallas and surrounding areas. We understand your loved one deserves more than having...
Always There Home Care Frisco TX is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Lone Star Visiting Caregivers is a Texas-based home care agency that prides ourselves on our carefully selected, trained caregivers who prioritize empathy and connection, ensuring clients receive reliable and respectful...
WAYMAKER HEALTH LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Inclusive Community Home Care is a licensed and professional home care agency that was founded in Frisco, Texas. At Inclusive Community Home Care we believe that all people in our community deserve to be cared for no...
Ansah Healthcare is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Dallas Texas Caregivers, we understand that as one ages, completing daily tasks and activities may become harder to do. Day-to-day living may become particularly difficult, especially for seniors who are suffering from...
CLASS ACT HEALTHCARE SERVICES, LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Revita Wellness PLLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
VIP Senior Care is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Machris Home Health Services Inc is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
There is no higher priority to our NolasHands Family than the safety of our clients and caregivers. We aim to keep all of you out of harm's way and to support you through this challenging time.
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...
At Cloud9 Private Caregivers LLC, we believe that compassionate care begins at home. Our experienced caregivers provide personalized assistance with daily activities, companionship, and specialized support, ensuring each...
At Always Best Care, we believe it’s a good feeling to be included in our clients' lives. Subtle smiles and long talks, showing kindness and humor during difficult times, providing the right levels of care – these are the...
C & C Caring Hands is proud to provide a high quality level of customer service, medical experience, and commitment to health and wellness to all our patients. Our experienced professionals put your healing needs first....
Our Mission Statement To make every day easier for our clients and their families by providing daily assistance infused with compassionate, personalized care and unwavering support. We are dedicated to enhancing quality...
Comfort Keepers is the leading provider of customized home care services for Carrollton, Coppell, Lewisville, Flower Mound, Farmers Branch, and Addison. Our independently owned and operated Carrollton office provides...
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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.