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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
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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:
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At Hope Group Home Care, our mission is to enhance the lives of individuals living with chronic illnesses in Hendricks County, Hamilton, Boone, Johnson, and surrounding counties.
Mujani Services in Indianapolis, IN, provides compassionate, non-medical in-home care to seniors and individuals who wish to remain independent and comfortable at home.
First Trust Home Care provides compassionate, caring, and personalized in-home care and transportation services for seniors in Indianapolis and the surrounding areas. With a comforting approach and support tailored to...
At Amazing Care Solutions, we understand that home is where comfort, safety, and peace truly live. That’s why our mission is to bring high-quality, personalized homecare services directly to you or your loved one. Based...
Shalom Care LLC provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily tasks, medical support, and companionship, creating a...
SYNERGY HomeCare of Northern Indianapolis is owned and operated by Trent Terry, a Master’s graduate in Business Administration who has since put his degree to use in multiple successful entrepreneurial ventures, ranging...
Golden Heart Senior Care offers the highest quality companion care, home care services and personal care services so our clients can live a full and independent life in the comfort of their home.
At Cater2U Home Care Service LLC our commitment is to transform the way in-home care is experienced—by blending compassion, excellence, and truly personalized support. Our mission is to help individuals live safely and...
We’re always there when you need us – ready to provide care in all ways. When faced with the decision to provide care, you need a trusted partner. One who has the knowledge gained from years of providing quality home care...
To be Indiana’s most trusted home care provider, delivering compassionate, personalized support that empowers individuals to live with dignity, independence, and enhanced quality of life in the comfort of their own homes.
Care When and Where It’s Needed Our home care services are available 24 hours a day, 7 days a week, 365 days a year, so you know your loved one’s needs are always being met. We offer care when and where it’s needed,...
Indiana Best Home Care Corp. is dedicated to providing compassionate, reliable, and personalized in-home care services to individuals and families throughout Indiana. Our mission is to support clients in maintaining their...
Care Span Homecare is a trusted home care agency in Indiana dedicated to providing compassionate, reliable support for seniors and adults who wish to maintain their independence at home. We specialize in companion care,...
We’re intentionally different. We set the benchmark for excellent home care by balancing our friendly nature, person-centered approach, and discreet services with our love of helping you maintain your independence. It’s...
Amana Personal Services Agency, LLC is a home care provider that services in Noblesville, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
First Priority Home Care, LLC is a home care provider that services in Noblesville, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Binman Home Care LLC provides dependable, compassionate care tailored to each individual’s needs. Our dedicated team helps seniors live comfortably and safely at home, offering support with daily activities and the...
Cortney’s commitment to the well-being of others goes beyond professional experience; it is a personal mission to make a positive impact in the lives of those who need support the most. Cortney leads the agency with a...
Peak Homecare Associates is a home care provider that services in Noblesville, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
COMFORT PALS is a home care provider that services in Noblesville, IN. 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 are the leader of compassionate, loving care for seniors and those with disabilities. Our service enables seniors to live independently in the privacy and comfort of their own home.
BEST SOLUTIONS HOME CARE LLC is a home care provider that services in Noblesville, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OASIS CARE LLC is a home care provider that services in Noblesville, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
FLORENCE KAY LLC is a home care provider that services in Noblesville, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
NZURI Horizons Home Care LLC is a home care provider that services in Noblesville, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
To improve quality of life for those we serve through the delivery of clinical excellence, extraordinary service and compassionate care, while being recognized as the leader in home health.
Balde Home Care Services LLC is a compassionate and reliable home care agency dedicated to enhancing the quality of life for seniors and individuals with disabilities. With a focus on personalized care, the agency...
Exceptional Residential Services Inc. is a trusted provider of high-quality, person-centered residential care. Specializing in delivering compassionate and individualized support for adults with developmental...
At TRS, we provide compassionate, personalized care that enhances the quality of life for our clients in the comfort of their own homes. We are committed to delivering professional, reliable, and empathetic...
OUR MISSION Our mission is to help our clients gain their independence while living at home where their treasured memories are; also, to treat our customers like our own family, providing them with first rate care!
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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.