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:
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...
The Heart is a symbol of love, compassion, and understanding. Our team of caregivers showcases their talents through love because we understand the courage it takes for our clients to accept help. The Lark is the only...
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...
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...
What makes us special here at Harvest is that we don’t limit ourselves and our services. We believe in going above and beyond for your clients. Our services are exclusive to Harvest and we believe in taking the time out...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
Dependable Health Services is our communities’ preferred choice for home health care services. We accomplish this through industry leading quality outcomes, exceptional customer experience provided by our team, and...
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...
Since 1984, the founders of Preferred Care at Home have had the privilege of assisting clients to improve their quality of life while still recognizing and maintaining their dignity and independence. Preferred Care at...
GenNext Home Care specializes in home care, home health and assistance for seniors, disabled adults and children. Our goal is to keep each client in their familiar surroundings as long as possible improving their 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...
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...
Senior Helpers of Scottsdale was proud to join the exceptional team of over 300 other Senior Helpers owners in 2007. Shaun Phelan was inspired to start providing quality care to the senior population after he witnessed...
At Nurse Next Door, we go beyond home care. We believe seniors should have choice in everything they do. We match you or your loved one with the perfect caregiver, with care tailored to fit individual needs. We also...
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...
At Comfort Keepers, we believe in elevating the human spirit through quality, compassionate in-home care services. Our dedicated caregivers provide personalized assistance with daily activities, companionship, and...
Amada Senior Care Phoenix West Valley's mission is to deliver the greatest quality in-home senior care and to assist families in managing their senior loved ones’ care needs. This entails identifying the finest caregiving...
Gold Star Home Care 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...
We provide more than just compassionate, personalized care at home and 24 hours. We provide you with friendship, someone to talk to and support as well.
At HomeWell, we address the immediate needs of clients while anticipating future challenges to bolster and protect their well-being as they age. We are dedicated to the long-term effects of a masterfully-crafted care...
Home—there’s no place like it. It’s where your memories are. Where you raised your family and where friends have gathered for life’s celebrations. It’s been your basecamp through good times and bad. And it’s where you...
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
Elena Home Healthcare Elena Home Healthcare is a family inspired business based on the generous heart of loving family members that served others in the greater Phoenix community for many years. Founded in 2020, Elena...
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,...
Arcadia Home Care - 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...
HomeWell Care Services of Phoenix, 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...
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...
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...
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...
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...
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...
Always Best Care combines national strength and standards with local accessibility and personal service. Your local Always Best Care team will be helping families throughout Tempe and surrounding communities providing...
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.
SYNERGY HomeCare of the East Valley and Pinal County employs hundreds of caregivers to assist with daily living activities in the comfort of your own home. Let us find the right caregiver to meet your needs. Our...
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...
Right at Home Northwest Phoenix knows aging is not easy. Not for the person who is feeling the effects of the years. Not for their family members. As a person begins to age, family members are often called on to help with...
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...
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. Golden Heart Senior...
Acti-Kare of Scottsdale, AZ offers in-home care services to Scottsdale and the surrounding areas that will help you or your loved be comfortable at home while you age or rehab at home. Remember, when you can’t be 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...
No matter their needs, our personalized in-home services help your loved one remain where they feel safe and help them actively engage in leading an enriched life.
We are an affordable alternative to assisted living facilities and nursing homes – we help our clients to stay in the comfort of their own homes. With our in-home care services, clients will not need to rely on family...
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...
The Heart is a symbol of love, compassion, and understanding. Our team of caregivers showcases their talents through love because we understand the courage it takes for our clients to accept help. The Lark is the only...
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...
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...
What makes us special here at Harvest is that we don’t limit ourselves and our services. We believe in going above and beyond for your clients. Our services are exclusive to Harvest and we believe in taking the time out...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
Dependable Health Services is our communities’ preferred choice for home health care services. We accomplish this through industry leading quality outcomes, exceptional customer experience provided by our team, and...
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...
Since 1984, the founders of Preferred Care at Home have had the privilege of assisting clients to improve their quality of life while still recognizing and maintaining their dignity and independence. Preferred Care at...
GenNext Home Care specializes in home care, home health and assistance for seniors, disabled adults and children. Our goal is to keep each client in their familiar surroundings as long as possible improving their 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...
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...
Senior Helpers of Scottsdale was proud to join the exceptional team of over 300 other Senior Helpers owners in 2007. Shaun Phelan was inspired to start providing quality care to the senior population after he witnessed...
At Nurse Next Door, we go beyond home care. We believe seniors should have choice in everything they do. We match you or your loved one with the perfect caregiver, with care tailored to fit individual needs. We also...
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...
At Comfort Keepers, we believe in elevating the human spirit through quality, compassionate in-home care services. Our dedicated caregivers provide personalized assistance with daily activities, companionship, and...
Amada Senior Care Phoenix West Valley's mission is to deliver the greatest quality in-home senior care and to assist families in managing their senior loved ones’ care needs. This entails identifying the finest caregiving...
Gold Star Home Care 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...
We provide more than just compassionate, personalized care at home and 24 hours. We provide you with friendship, someone to talk to and support as well.
At HomeWell, we address the immediate needs of clients while anticipating future challenges to bolster and protect their well-being as they age. We are dedicated to the long-term effects of a masterfully-crafted care...
Home—there’s no place like it. It’s where your memories are. Where you raised your family and where friends have gathered for life’s celebrations. It’s been your basecamp through good times and bad. And it’s where you...
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
Elena Home Healthcare Elena Home Healthcare is a family inspired business based on the generous heart of loving family members that served others in the greater Phoenix community for many years. Founded in 2020, Elena...
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,...
Arcadia Home Care - 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...
HomeWell Care Services of Phoenix, 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...
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...
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...
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...
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...
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...
Always Best Care combines national strength and standards with local accessibility and personal service. Your local Always Best Care team will be helping families throughout Tempe and surrounding communities providing...
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.
SYNERGY HomeCare of the East Valley and Pinal County employs hundreds of caregivers to assist with daily living activities in the comfort of your own home. Let us find the right caregiver to meet your needs. Our...
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...
Right at Home Northwest Phoenix knows aging is not easy. Not for the person who is feeling the effects of the years. Not for their family members. As a person begins to age, family members are often called on to help with...
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...
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. Golden Heart Senior...
Acti-Kare of Scottsdale, AZ offers in-home care services to Scottsdale and the surrounding areas that will help you or your loved be comfortable at home while you age or rehab at home. Remember, when you can’t be 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...
No matter their needs, our personalized in-home services help your loved one remain where they feel safe and help them actively engage in leading an enriched life.
We are an affordable alternative to assisted living facilities and nursing homes – we help our clients to stay in the comfort of their own homes. With our in-home care services, clients will not need to rely on family...
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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.