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.*
✔
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,...
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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...
Welcome to Visiting Angels of South Phoenix! We proudly serve the communities of South Phoenix and surrounding areas, including Ahwatukee Foothills, Maricopa, Buckeye, Laveen, Surprise, and Waddell. Our non-medical home...
We provide Core In‑Home Care Services Personal care: Assistance with bathing, dressing, grooming, toileting, incontinence care, and hygiene support , obility & transfer help: Aid with transferring, walking, fall...
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Cornerstone Caregiving specializes in providing comprehensive healthcare solutions tailored to meet the diverse needs of our clients. With a commitment to excellence and a focus on patient-centered care, we deliver...
One You Love Homecare Northwest Valley (Greater Phoenix area) proudly serves Maricopa county primarily in Phoenix, Glendale, Peoria, Sun City and Sun City West. Our mission is to provide exceptional, personalized...
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Brightwood Health is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Care With Grace provides compassionate, non-medical in-home care services throughout Maricopa, Arizona. Caregivers assist seniors with daily activities such as personal care, companionship, meal preparation, medication...
HomeWell Care Services of Glendale, AZ is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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At Mary Lou’s Helping Hands, our foundation is built on faith, family, and compassion. We believe caregiving is not just a service — it is a calling placed on our hearts by God to serve others with love and dignity.
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Tender Heart Home Care is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Griswold is an award-winning pioneer in the home care industry, with over four decades of experience and a storied legacy of compassion and integrity. We believe Care Professionals are the foundation of our success, and...
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Nursecore of Phoenix is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Generations At Home Wellness Care is the perfect solution for seniors and others who wish to enjoy the privacy and comfort of their own home for as long as possible and still maintain their independence. We can help those...
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Alpha Healthcare, Llc is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bayada Nurses is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HomeWell Care Services of Scottsdale, AZ is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Touching Hearts at Home of AZ is a home care provider that services the West Valley. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
Home With Help is a trusted provider of comprehensive non-medical companionship / home-making and Personal Care Services in the Greater Scottsdale, Phoenix Arizona. We are committed to providing the most compassionate,...
Seniors Helping Seniors® Scottsdale's 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...
Home Matters Caregiving is compassionate care you can depend on. Discover the benefits of professional caregiving in the comfort of your home. Learn how a Professional Caregiver can help create great days for your...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Northwest Phoenix or in surrounding areas like Glendale, Peoria, or Surprise
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Phoenix or in surrounding areas like Downtown, Midtown, or Tempe.
Our caring and experienced caregivers provide up to 24 hour care under the supervision of our nurses in the comfort of your own environment, at affordable rates. We run a comprehensive background screening on each...
Griswold Home Care is available to assist you and your family with your home care needs. We specialize in providing quality home care with consistent, experienced caregivers, including live-in home care.
Senior Helpers of Tempe was opened by owner John Skelton in 2020 as a mission-driven business for the greater good. John and his dedicated team recognize the growing need for in-home care services and are committed to...
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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.