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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:
At Homily Care Agency, we offer a wide range of health care services for disabled and elderly individuals in the comfort of their own homes. Our dedicated team ensures that our clients receive the best care and attention...
Luthas Heath Care is dedicated to providing compassionate and professional home care services to seniors and individuals with disabilities. We understand the importance of independence and aim to support our clients in...
HomeWell Care Services of Andover, MA is a home care provider that services in Lowell, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elite Nursing Network Agency offers comprehensive staffing solutions for nursing homes and at-home care services. With a team of highly skilled professionals, we provide personalized attention and support to enhance the...
Welcome to Golden Hands Healthcare, where every touch is golden and every patient is cherished. Come home to care that feels like family. At GHHC, we believe in treating every individual with LOVE, DIGNITY and...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Woburn. Our trusted Woburn staff can’t wait to meet your loved one. We want to know how many times...
Comfort is Key Our mission is to provide the best care for our clients in an environment they love and are comfortable with. We proudly work with a team who believe in professionalism, integrity and most important are...
At MEY HOME CARE SERVICES, we are dedicated to providing exceptional non-medical home care services. Our mission is to ensure that our elderly clients can stay comfortably in their own homes while receiving compassionate...
Mary-Mac Homecare Services offers compassionate and personalized in-home care for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical needs, and provide warm...
Mee Services LLC is a home care provider that services in Lowell, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Staffing Options is a trusted homecare provider, dedicated to delivering compassionate, personalized care in the comfort of your home. Our skilled professionals offer a wide range of services, including daily living...
Gracious Touch Staffing and Home Care LLC is a home care provider that services in Lowell, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ComForCare of Lowell, MA is a home care provider that services in Lowell, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to provide support and excellent care to seniors who face various challenges of aging, and to children who wish to improve their overall quality of life in Massachusetts including Middlesex, Worcester,...
Safe, Quality Care From Reliable Professionals Each one of our trained caregivers is carefully screened to ensure each patient’s safety and security. We perform in-depth personal interviews, verify applicant’s prior...
VNA of Greater Lowell Inc is a home care provider that services in Lowell, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Brymac Staffing LLC - Lowell, MA is a home care provider that services in Lowell, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
RealCare SeniorServices - Our mission is to provide high-quality, personalized home health care that supports our clients in living safely and comfortably in their own homes. We aim to be an extension of the family,...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Lowell, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
PACE at Element Care provides complete and highly personalized care to help seniors live independently, safely and comfortably in their homes for as long as possible.
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 by providing compassionate care in the...
It is our vision to be the best support system that eases pain for families going through the challenges of caring for their declining loved ones. We also work to facilitate opportunities for compassionate caregivers...
For over 20 years Right at Home has provided personalized in-home care and support for seniors with care and compassion. Our caregivers are trained to help with everyday tasks that have become challenging. This may...
Senior Helpers is the premier provider of senior care, wherever your senior resides. We provide in-home care and personalized care in the comfort of your own home and at other residential locations including assisted...
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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.