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.*
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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:
Serenity Hands Healthcare LLC is a compassionate home care agency dedicated to enhancing the quality of life for seniors and individuals with health challenges. We provide personalized, non-medical support in the comfort...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in North Milwaukee or in surrounding areas like Elm Grove, Wauwatosa, or Brookfield.
R&K Support Services is a company that offers assistance to individuals with disabilities, the elderly, and general care services for anyone. Offering daily living skills and independent living skills such as running...
Assisting Hands Home Care of Southwest Milwaukee is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Through innovative personal care services, we exercise a commitment to excellence, improving health and quality of life one client at a time. Our exceptional services will add value to each client’s life, and in the...
Pearl's Life House is focused on providing care services to individuals with special needs in Wisconsin based on Christian morals and ethics. Our mission is to exemplify exceptional care through hope, love, and joy. We...
We know there’s no place like home. That’s why HomeWell brings you the highest quality of care so you can maintain your independence and experience life to the fullest.
Senior Helpers of Glendale advocates for the highest quality of in-home care for seniors in the Glendale and surrounding Milwaukee community. Owner Jamie Miller has a passion for helping the elderly that began when he was...
Abundance Healthcare Services LLC is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ans Home Hlth Svc is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angel Homecare is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to provide the best home care service for you and your loved one at the comfort of your home so you can be close to your family for as long as you can.
Aurora Visiting Nurse Association of WI is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Covenant Care is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DIVINE PATHWAYS is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carriage Of Caring of Milwaukee, WI is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
By Your Side Hospice - Milwaukee is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Assisting Hands Home Care, we understand. Our trained dependable caregivers and personal assistants can help overcome those challenges, and make home an even better place to be. We include everything from...
Buford Personal Care is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amedisys Home Health is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DEJIA HOME HEALTH CARE is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
COMPASSIONATE HEALTHCARE LLC is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
An In Home Supportive Care Agency provides services in the patient?s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with...
ASSURANCE HOME HEALTH CARE is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ADORE HOME HEALTH is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Above Care is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ADVENT HOME HEALTH SERVICES is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aaran Home Care of Milwaukee, WI is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Affiliated Home Hlth Care is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to meet the client’s needs as if they were our own. By meeting the client’s needs we (staff) will act in a professional manner at all times, while providing excellent services. This means delivering...
Dementia Support Specialist, LLC of Milwaukee WI is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DIVINE PERSONAL CARE AGENCY is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aseracare Home Health is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Camillus Cares Home Hlth is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Better Living Home Healthcare is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Agape Home Health Care of Milwaukee, WI is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AAA Care Services is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Community Home Health Care, Inc is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Brighter Site Inc. is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Anew Home Hlth Care is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Blessed Healthcare is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amity Health Services of Menomonee Falls, WI is a home care provider that services in Milwaukee, WI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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'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 are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in South Milwaukee or in surrounding areas like New Berlin, Greenfield, or Franklin.
BrightStar of Central Milwaukee is driven to serve people. Our values reflect a strong commitment to the highest quality of care, above and beyond customer service, and outstanding communication. Our staff is determined...
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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.