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:
Alpha Homecare LLC, Compassionate In-Home Care Services At Alpha Homecare LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence. Our...
Exceptional Care for Your Loved Ones Our mission is to provide exceptional support to your loved ones in their golden years or those facing well-being challenges. Bella Vie Homecare LLC delivers premier care services...
We are a dedicated healthcare provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity. Based on...
Green Meadows In-Home Care is dedicated to providing compassionate, reliable, and personalized care for individuals who wish to remain in the comfort of their own homes. Our team focuses on promoting independence,...
At Senior Helpers, we are here to help anyway we can -- no matter how big or how small the task. Our owners, Sandy and Hector Muñoz, know personally what it's like for the people in need of care and the toll it takes...
At California Caregiving Central, we’ve made it our mission to be the state’s trusted center for quality, non-medical home care. From bustling cities to quiet coastal towns, our caregivers bring dependable support,...
We know there’s no place like home. That’s why we bring the highest quality of care right to your front door. With a personalized care management approach and a dedicated team of compassionate caregivers, you can expect...
Home Helpers Home Care of Orange Coast is more than an in-home health care agency – we’re your extended family when family can’t be there. We’re a locally owned, trusted provider of quality, compassionate in-home care in...
When you and a loved one in your life require care assistance, Executive Home Care is ready to lend a hand. Find out more about the expert and compassionate senior living care that is offered in the comfort of one’s own...
At Amity Elderly Care Services, we believe care built on friendship and respect makes every day brighter. Our caring team provides individualized support from daily living help to meaningful companionship and specialized...
BlueSea Care is a cutting-edge thought leader in non-medical in-home care for seniors. Our focus is an emphasis on compassion, respect, wellness, and purposeful engagement. Our mission is helping your loved ones stay...
Feeling secure, respected, and cared for matters for everyone—especially seniors, people with disabilities, and individuals seeking assistance at home. Homewatch CareGivers of Mission Viejo is committed to supporting...
Our Mission Loving Arms Caregiving is to be the leading home care agency in CA, renowned for our unwavering commitment to excellence, compassion, and innovation. We envision a future where every individual receives...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
At FirstLight Home Care of Mission Viejo, we provide exceptional care so that your loved one has the support they need to enjoy the quality of life they deserve in the place they call home. We exist to help people have...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
CARE PLUS HOME CARE, INC. is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TheKey of Laguna Hills, CA is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
COASTLINE HOMECARE is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Parentis Home Care is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Each member of the Amada Senior Care team in Orange County is dedicated to going beyond basic in-home care by gaining a deep understanding of our clients and their individual needs so that we can make a truly positive...
Atiya Care LLC is a home care provider based in Laguna Hills, CA 92653, offering services that enable seniors to stay safely in their own homes while receiving needed medical or personal care support.
Saddleback Coordinated Home Care is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Best Helping Hands provides non-medical, in-home care for Seniors and any person with temporary or permanent special needs, such as Alzheimer's, Dementia, post-operative recovery, rehabilitation assistance, etc. Services...
Alta Home Care is dedicated to providing personalized care that enriches the lives of our clients and helps them maintain the highest level of independence. Every Personal Attendant is carefully screened, selected, and...
Abiding Home Care LLC of Laguna Hills, CA proudly provides non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and...
Home Care Of America, Inc is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Plus Nursing Services is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARE PLUS is a locally owned & operated company providing our clients with CLINICAL EXCELLENCE and SUPERIOR SERVICE throughout Orange County and surrounding areas.
Duplicate - Home Helpers Home Care of Laguna Hills/Orange Coast, CA is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical...
BC ACUTIS, INC. is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Why worry? LET US HELP... because WE CARE! Responsible, Professional, Affordable, Reasonable, and Dependable. Our Caregivers/CNAs provide everything from companionship to Full Service. In-home, In-facility,...
Level Home Health, Inc is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We provide non-medical custodial care to seniors and people with disabilities by designing and implementing a customized plan of care tailored to individual needs. We serve Orange County and portions of surrounding...
Our Vision is to provide the highest quality of care and service 24/7 in a home like environment. • To provide Residents, Families, Friends and Staff with a warm, friendly, healthy and safe environment to live and work.
RC HOME CARE, INC. is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sea Crest Home Health Services Inc is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
COMPASSIONATE IN-HOME CARE is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We provide in-home, non-medical care to your loved ones, from newborns to seniors. Accessible's professional team with extensive Health Care experience is committed to be there with "Compassionate Care" during your...
All care is Managed and supervised by Registered Nurses at no extra cost. Healthy At Home is dedicated to ensuring that seniors and disabled individuals are able to remain in their own homes safely and with the highest...
Right at Home - Laguna Hills, CA is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Safe Guard Care Services, our mission is to provide compassionate, high-quality, and personalized care that enhances the well-being and dignity of every individual we serve. We are dedicated to fostering a safe,...
Good Neighbor Care Service provides compassionate and personalized in-home care for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical support, and companionship,...
Acti-Kare of South Orange County ( Duplicate) is a home care provider that services in Laguna Hills, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
President and CEO of Interim HealthCare of Irvine, Khushbu Dadlani, has spent the past 10 years caring for and educating preschool children. Faced with the challenges of caring for her own parents-in-law, Khushbu’s...
As a family owned, not for profit organization, Canaan Home Care is at the forefront of the home care industry. Canaan has been a partner of the State of California for over 25 years, together, raising the home care...
At Golden Years Home Care Solutions Inc – San Diego, our mission is to provide compassionate, personalized, and dependable home care services that empower seniors and individuals with disabilities to live safely,...
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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.