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.
✔
I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
✔
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:
Comfort Keepers is here to help seniors thrive safely while living independently at home. Our empathetic caregivers are specially trained to provide uplifting care, transportation and support. From driving to doctor’s...
Our Goal is to help individuals improve their quality of life and provide holistic care for their individual needs and goals. We understand that home care is personal. Patients and their families need to feel comfortable...
ElderCrew delivers the pinnacle of personalized care with our high-quality private duty aides, dedicated to enhancing lives both at home and in assisted living facilities.
We provide reliable homemaking services that help clients maintain independence where they feel most comfortable. Whether you need an extra hand a few times a week or daily support, our flexible plans make it easy to get...
Ideal Care provides compassionate, professional home care to seniors across southern Connecticut. We offer personalized support, including specialized dementia care and dependable elderly care services designed to promote...
Our goal is for you and your loved ones to feel that you are safe and secure in your own home. We want to be there to facilitate your independence by assisting with some of the more difficult aspects of life you or your...
At VCCHA we are dedicated to providing exceptional care and support to individuals and families in the comfort of their own homes. Our compassionate and experienced team of caregivers is committed to enhancing quality...
We are a non-medicare certified agency which allows us to offer our services at a more affordable rate. We specialize in providing assistance to both seniors and persons with disabilities. We are committed to ensuring the...
Dependable Home Care provides the best services you deserve at the safety and comfort of your own home. Our aides are reliable and compassionate. You can rest assured that you're in good hands.
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...
Vip in home care services gives seniors freedom despite limited mobility, chronic conditions, and other age-related considerations. We understand the struggle family members face when a loved one needs extra assistance...
After working in the home care field as an aid for 18 years and spending 5 years working behind the scenes, Ms. Fulmore decided to take a leap of faith to start her own agency, to control the quality of in-home care...
At RMMK Homecare, we are dedicated to providing compassionate and professional care to help you or your loved ones live comfortably and independently at home. Our team of experienced caregivers is committed to delivering...
VNA Services, Inc is a home care provider that services in Hamden, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Visiting Nurse Services, Inc of SO CT is a home care provider that services in Hamden, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At VCCHA, our dedication is to enrich the lives of our clients and their families through exceptional homemaking and companion services. Our mission is to provide comfort, support, and a profound sense of dignity to those...
OOB Seniors Helping Seniors - Hamden, CT is a home care provider that services in Hamden, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
GRISWOLD SPECIAL CARE The World’s Oldest Multinational Non-medical Homecare Company Trusted Homecare at Affordable Rates GRISWOLD SPECIAL CARE refers Caregivers who provide companionship, homemaking, and personal...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Hamden, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Viera Homecare is your leading provider of world-class homecare services in Connecticut. We specialize in helping seniors maintain their independence while providing peace of mind to their families and loved ones. We also...
At SENIOR HELPERS of Upper Fairfield, New Haven, and Central Connecticut, we are dedicated to supporting families in our community with personalized care, no matter how big or small the task. Our mission is simple: to...
Compare Home Care Agency Costs & Services
×
Success!
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.