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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:
Senior Solutions is a non-medical comprehensive home care agency that trains caregivers who assist our clients with activities of daily living in their own homes. In recent years, we have also added service lines to help...
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It is with pride that we provide you with experienced and capable staff at Divine Home Care & Staffing Agency. For years, we’ve assembled an efficient team that brings first-rate health services to your homes in...
Charlotte Web Private Home Care, LLC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Just as growing older can allow for a more relaxed lifestyle, it can also present new obstacles and challenges. Our clients have peace of mind knowing that we are dedicated to their satisfaction and quality of life. We...
Kindly Companions, founded by cybersecurity expert and professor JT Folson, blends compassionate in-home care with modern digital wellness. Inspired by his experience caring for his mother, JT created a service that keeps...
You deserve to have the optimum level of health and comfort. Whenever life’s difficulties hinder you from achieving wellness, then we are here to provide you with home care services that are specifically structured to...
Blissful Hearts Healthcare Services LLC is a trusted in-home care agency dedicated to providing compassionate, reliable, and personalized support to individuals who wish to remain in the comfort of their own homes. We...
Learn Today Save Lives Tomorrow Home Care, LLC is owned and operated by healthcare professionals who are dedicated to delivering quality care. We provide customized service that is delivered in the comfort of your...
Conscientious Home Health Care is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
THE COLOR OF EXCELLENCE LLC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Trulicare LLC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Healing Hands Private Care, LLC in Lithonia, Georgia has been providing home health care services since 2012. Healing Hands provides services for individuals who prefer to stay at home and live comfortably in their own...
Regal Homecare and Concierge LLC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
We are a family owned recreational and educational center that takes pride in providing exceptional services in a loving and caring environment for your family members, individuals with dementia ,autism, alzhemiers and...
Teric Private Home Care Inc is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Content Health Care Services is dedicated to providing comprehensive and compassionate home care solutions that prioritize the well-being and contentment of our clients. Our mission is to enhance the quality of life for...
TOP LEVEL HOME CARE LLC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TOOLOP,LLC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Renaissance Care of the South offers 'Peace of mind' by providing Homecare services that help individuals and families live and perform their best. We do this by nurturing the mind, spirit and body. We are available any...
His Grace Home Care is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARING FIRST HEALTHCARE SERVICES LLC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Through professionalism, integrity, and excellence, Micole Health Services strives to provide compassionate and high-quality care to both our patients and their families. Ultimate Home Health Group was formed on the...
Golden Bridges Private Home Care LLC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Personalized Care, LLC and thank you for your interest in our company. Personalized Care, LLC is an in-home care provider of home care services and we've been in the private home care industry for over 11...
Open Door Restorative Care LLC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OSTONIA HEALTHCARE INC is a home care provider that services in Lithonia, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
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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.