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:
Homecare Companions is a non-medical in-home care agency founded in 2022, dedicated to providing compassionate and personalized support for individuals who need assistance with daily living activities. The agency focuses...
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...
Care America HomeCARE is a provider of home care in Orange County California that offers assistance to individuals with daily living and companionship. Our team of dedicated and compassionate professionals is comprised of...
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...
Our home care services and compassionate caregivers help older adults live independently in their own home and continue to do all the things they love. We do not just assign caregivers to a job. We match our 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...
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...
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...
Being an essential service provider, Amada Senior Care is here for you 24/7 as we continue to operate through COVID-19. Count on Amada’s commitment to promoting your health and safety as a factor you can control during...
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...
Home Instead - Irvine, 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 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...
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...
CARE PLUS is a locally owned & operated company providing our clients with CLINICAL EXCELLENCE and SUPERIOR SERVICE throughout Orange County and surrounding areas.
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...
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...
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...
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...
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,...
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...
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...
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...
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...
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...
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...
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...
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 care or...
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...
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...
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...
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.
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.
Acti-Kare of South Orange County 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...
When you or your loved one need help at home, turn to FirstLight Home Care of Irvine. We offer complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just...
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...
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...
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,...
Our personalized care plans emphasize helping our clients maintain their dignity and self-respect while providing peace of mind, companionship, safety, and supervision. Our clients choose the caregiver, schedule, and...
At Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations as...
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.