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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.
✔
I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
✔
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:
Comfort Keepers of Montclair, NJ is a home care provider that services in Newark, NJ. 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 proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
United Home Care of Newark, NJ is a trusted home care agency dedicated to providing compassionate, high-quality support to seniors in the comfort of their own homes. With a focus on personalized care, the agency offers a...
Our goal is to promote independence for our clients by providing compassionate care in the comfort of their homes. patient Often individuals require assistance with one or more of their activities of daily living such...
Cedas Home Care is a RN owned home care company that assists individuals and families in caring for their loved ones. We are dedicated to helping our clients lead dignified and independent lifestyles at home, in a nursing...
Our mission is to improve the quality of life for our clients and their families by delivering compassionate and aordable home healthcare services. We strive to be the leading provider of home health care in our...
Our mission is to support the health and well-being of our clients by delivering the finest personalized in-home care, specific to their needs, wants and preferences
Our services and schedules are customizable, so whether you or your loved one are looking for assistance for just a few hours a day or around-the-clock, we can accommodate your needs. During your free In-Home Care...
We understand that reliable home care is where our clients feel most comfortable. Therefore, we work tirelessly to make sure that they continue to live independently while receiving the care they need. Whether it's...
At Carebridge Health Services LLC, we offer personalized home care solutions designed to enhance the well-being, comfort, and independence of our clients, delivered with compassion and professionalism.
Essex Valley VNA Inc is a home care provider that services in Newark, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Committed to Care Old age brings with it a lot of joy, however, there are some challenges to it as well. If you have a loved one whose needs align with our mission and services, then give us a call. We can promptly...
Progressive Home Care is a home health agency, based in Newark, NJ. We have been in business for four years but our directors have well over a decade of experience in the home health care field. We here at Progressive...
Alvita Care is a leading home care provider in New York City, Westchester, Long Island, and New Jersey. We’re best known for in-home senior care, but our caregivers are available to people of all ages, physical...
Bethjane Heart Home Care Services is a compassionate and dedicated home care agency based in Newark, New Jersey. Our mission is to provide exceptional non-medical care and support to individuals in the comfort of their...
PRIORITY GROUP SERVICES LLC is a home care provider that services in Newark, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Siloam Community Services Corp is dedicated to delivering compassionate, high-quality home care services that empower individuals to live safely, independently, and with dignity in the comfort of their own homes.
Henlucy Health System LLC is a home care provider that services in Newark, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Loving Care Agency is a home care provider that services in Newark, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Holy Mother Total Care LLC is a home care provider that services in Newark, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Finders Total Care LLC of Newark is a home care provider that services in Newark, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
WeCare Home Care - Newark, NJ is a home care provider that services in Newark, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Complete Health Care, LLC, we are passionate about helping people through individualized services that are designed to meet their unique needs. Our staff is dedicated to improving the health and well-being of all our...
We understand that a leap of faith is often involved when family members consider home care for their love ones. While many families hope for the best, we do not believe in leaving home care to chance. Best Home Care is...
Amme Community health and Wellness Center, Inc is a home care provider that services in Newark, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
Royal CareGiver’s is a local, family-owned, boutique care agency. Similarly it focus on maximizing the health and quality of life of each individual we serve. In conclusion with over 5 offices strategically located from...
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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.