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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:
Our in-home care services brighten the lives of seniors, who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier through compassionate support,...
Home Instead can help with compassionate, home senior care services delivered right in your loved one's home. Whether a few hours a day or long-term care 24 hours a day, a CAREGiver can assist you. All CAREGivers are...
At AmeriCare, we work hard to find caregivers who love what they do and recognize the impact they have in their client's lives. We understand the importance of finding people who can be trusted and we work together as a...
Entrusted Heart Homecare is powered by a seasoned team that brings a wealth of knowledge and dedication to every aspect of patient care. We understand the intricacies of healthcare and the importance of a personalized...
Assisting Hands of Fremont CA is a home care provider based in Newark, CA and serves Alameda County. Whether it’s help with daily activities, personal care, safety concerns due to cognitive decline, or the desire to...
Arcadia Home Care - Livermore, CA is a home care provider that services in Livermore, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With the knowledge I gained from my own experiences, I'm committed to creating a home care service that truly makes a difference, offering families the peace of mind that their loved ones are in caring and capable hands....
We’re here for you! Since 2018, Affinity at Home Care, has delivered quality in-home care, supporting older adults with a wide range of needs and age-related conditions.
ComfortKeep Home is a professional and compassionate home care service provider dedicated to improving the quality of life for seniors, individuals with disabilities, and those recovering from illnesses or surgeries.
Atlas Home Health specializes in long-term, private duty home care for both adult and pediatric clients. Each client receives one-on-one support from a dedicated caregiver or care team, with services ranging from basic...
Assisting Hands exemplifies compassion, dependability and dignity to all of our clients. Our company was founded on the principles of caring for others in a way that we would also want to be cared for, which is made...
Golden Hope Services is a reputable home care agency dedicated to providing compassionate, personalized in-home care services for seniors and individuals with disabilities.
Senior Helpers of Danville was founded in 2007 and purchased by Nicholas Magnusson in 2014. He became passionate about working with Seniors through his experience working as a Administrative Director at UCSF Medical...
Senior care matters deeply here in the East Bay Area, where our senior population continues to grow and become more diverse. It's all about improving the lives of our older community members, ensuring their safety, and...
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...
We at FirstLight Home Care exist to help people have their best day, every day. Our mission is to provide compassionate home care so that the families we serve have peace of mind knowing their loved ones are receiving the...
Care Indeed provides non-medical home care services to seniors: personal care, support with mobility, help with household chores, companionship, and transportation. We also send our trained and experienced caregivers,...
At Homewatch CareGivers of Pleasanton, we're not just another in-home care company. We're a lifeline for families and individuals needing compassionate, personalized care. Our services cater to a diverse range of needs,...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
Professional HealthCare At Home is a leading home care provider in the western United States with services ranging from skilled nursing and rehabilitative therapy to private duty medical and non-medical care. With...
About Right at Home Livermore Valley John Clauser grew up just next door to Livermore in the Pleasanton area. He temporarily moved away while attending the University of the Pacific where he studied business...
At GIMAG HEALTHCARE, we are proud to be a family-owned and operated agency that listens and is truly present with patients and clients that we are privileged to serve. For years, we have been providing skilled,...
Preserving Dignity with Passionate Care Proudly serving the East Bay www.elite-phcs.com Keeping you or your loved one in a secure and comfortable environment and helping families fulfill and maintain relationships as they...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
AuCare of Livermore, CA is a home care provider that services in Livermore, 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 Livermore and Brentwood, CA is a home care provider that services in Livermore, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
There is an incredible demand in our society for care professionals, and we are proud to be up to the task. And it's not just for seniors — if a member of your family needs help, we're the place to call. As we are a...
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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.