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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 A Special Place Home Care, we are committed to providing professional and personalized care. Our goal is to meet and exceed all of your expectations of care. Our staff members are dedicated to providing you with the...
Healing Hearts Home Care, LLC, Compassionate In-Home Care Services At Healing Hearts Home Care, LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
Heavenly Sent Home Care Services is a unique and customizable home care service provider with a suite of services that allows elders to age gracefully and safely in the warmth of their homes.
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Absolute Care Services of NC, LLC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hand on Heart Home Health Care, LLP is a home care provider that services Greenville, NC 27834. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal...
My PCA Greenville Home Care is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We know there’s no place like home. That’s why HomeWell brings you the highest quality of care so you can maintain your independence and experience life to the fullest.
SILVERcare-Greenville-NC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Here at Restorative Care HomeCare LLC, we are effective at improving patient outcomes. We encourage our clients to focus on their abilities and not their limitations. Our ultimate goal is helping our clients reach their...
Addus is proud to be a nationally recognized provider of high quality, in-home care services with over 30 years experience. Our breadth of services include Contractual Home Care, Personal Care, Homemaker, Respite, Care...
Young at Heart Elderly Sitting Service, LLC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Life Care Inc is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
East Carolina Outreach, Inc. is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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 Visiting Angels of Greenville, we provide kind, attentive home care for Morehead City area seniors. Our in-home support offers many seniors the chance to remain at home and avoid the move to a care facility. The goal...
Majestic Support Services, LLC - Greenville - NC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Health - Pro Home Care Services, Inc. is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
H&B Uplifting Services, LLC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CBHomeCare and our Family of Providers are proud to be known as a leader in providing reliable, high quality personal care, companion care and private duty homecare to families and seniors.
Heart Felt TLC, LLC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cornerstone Caregiving--Greenville, NC combines home care with a personal touch, ensuring that your loved ones are treated with respect and compassion. Our team of skilled caregivers and supportive office staff provides...
MCR Home Health, LLC-Greenville-NC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Compassionate Home Care Services possesses a heartfelt desire to work with seniors in the community. It is our ultimate goal to forge extraordinary relationships between our clients and their Care Professionals. When...
Tar Heel Home Health is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
C & S Home Care, Inc. is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Vision Beyond Home Care Services, LLC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our House Homecare Services is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
University Health Systems Home Health and Hospice is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Zoe Life Clinical Services, LLC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Infiniti Home Care-Greenville-NC is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The home care service that CarePartners provides offers a precious alternative to facility living for many seniors in North Carolina. We provide not only care, but also the opportunity for independence, for our clients...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
Beyond Measure Care is a home care provider that services Greenville, NC 27858. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and other...
Gingerly Home Care, Inc. is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Healing Hearts Home Care is a home care provider that services in Greenville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our BrightStar Care team is available to help you and your family 24 hours a day, 7 days a week. We bring our quality home care services to these and other local communities.
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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.