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.
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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:
At SYNERGY HomeCare, we build connections and forward momentum in people’s lives. We call it the Synergy Effect. We believe our purpose is to provide the best care possible. Equally important is helping people feel, see...
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...
A Passion for Serving Seniors and their Families Our families live and work around the Hillsboro, OR. area, so we're invested in our community on a very personal level. And we believe every family in the area deserves...
Finding in-home and respite care can be stressful and confusing. However, it doesn't have to be that way. At Senior Helpers Portland West, we have supported hundreds of Oregon families and are here to help you or your...
Home Matters Caregiving is locally owned and operated by medical professionals and has been in business since 2007. We are located in the heart of Beaverton and hold the highest level of in home care licensure.
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...
In 1997 No Worries created a new model for providing Premier Comprehensive In-home Care in the Portland Metro area…We included caring for our Caregivers.
Our founders, Paul and Lori Hogan, launched Home Instead in 1994 to provide care to Paul’s 90-year-old grandmother. Remarkably, after she began receiving personalized, in-home care that allowed her to age safely in the...
Northwest Senior Management Services, Inc. is a geriatric health care company providing complete assessment and diagnosis of the health of the elderly by a highly experienced Geriatric Nurse Practitioner. We examine the...
Sinai Family Home Services is a non-profit licensed in-home care agency serving the Portland Metro area. It founded as a joint operation by Cedar Sinai Park and Jewish Family and Child Service of Portland. Services range...
We believe that caregiving is our life’s calling. Our family has been in the industry since 2005 and understands the difference that truly compassionate, personalized in-house care services can make. Serenity Home Care is...
Right at Home is a leading provider of non-medical, private duty supportive in-home care. Right at Home has over 100 offices throughout the US and has been providing quality home care since 1995. Our mission statement is...
At Your Home Care, LLC is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Select Home Care of Portland, OR is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Fedelta Home Care Services of Portland, OR is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
ZARA HOMECARE, LLC is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Providence Home Health is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HDE Home Care is a family owned and operated in home care agency. We improve the quality of life for seniors and people with disabilities by providing caregivers for one-on-one assistance with activities of daily living....
Carol Pardue started Family Matters in 2002 and now, with her three sons, they have over 150 amazing care providers in Portland, Oregon and in San Francisco Bay Area and San Diego, California. All providers are employees...
Kaiser Permanente Home Health is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Instead - Portland, OR is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Dwell Care: Leading the Way in Award-Winning, Wellness focused In-Home Care At Dwell Care, we pride ourselves on delivering award-winning, wellness focused in-home care for seniors and adults needing assistance with...
Rescue Life Senior Care Agency is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Instead - Portland, OR is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Lagom Care is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
EQC Home Care Agency is a dedicated provider of high-quality, compassionate home care services designed to support individuals in maintaining their independence and well-being in the comfort of their own homes.
Amedisys Home Health Care is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care offers a wide variety of high-quality services—from in-home care to medical staffing. If you are looking for a trustworthy care provider or staffing partner in the West Portland, OR area, please contact...
We are a local and privately owned registry dedicated to serving seniors who are in need of some help and want to continue living at home. A Loving Touch in Senior Care has been serving clients throughout the greater...
ComforCare Home Care - Portland, OR is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mercy Home Care Agency, LLC is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Portland, OR is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comfort Keepers elevates the human spirit for today’s seniors and their families through a unique, individualized approach to care that helps seniors thrive and achieve greater well-being by fostering everyday positive...
For seniors and those wanting to maintain an independent lifestyle at home, we provide dependable caregivers as an extended family member. Health and safety is always a priority in the service we provide, as well as...
G & J In Home Care, is a family owned and operated services bringing you the best support to your home, helping you maintain your familiar routines and discover new adventures. Our goal is always to put you first and to...
Signature Home Health & Home Care is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The mission of Home Helpers Home Care is to treat your loved ones with the same care and compassion as if they were part of our extended family. We focus on keeping them safe, independent, and comfortable in their own...
Adventist Health Home Health is a home care provider that services in Portland, OR. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
There comes a time in each of our lives when we or our loved ones need medical assistance. If you or your loved ones are facing health problems, be they temporary or chronic, it may be time to reach out for...
Quality Portland Home Care Services You Can Trust. The moment you’ve been dreading has arrived. It’s time to look for in-home care in Portland for a beloved family member. No matter your age, caring for someone who...
AmeriCare® HomeCare of Oregon ...because time spent with loved ones should be cherished! This may be your first time exploring care options or an ongoing research. Either way, we truly understand the decisions you face...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead Senior Care® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance...
As a leading provider of in-home care and at home senior care services, our expert caregivers provide customized care plans crafted to the individual recovery needs and daily living requirements for clients throughout...
Integrity In-Home Care provides professional, affordable, and caring in home living assistance for seniors in the greater Portland, OR area. The care services we provide are the following: Caring Companionship,...
At Blesseded Hands Home-Care, the need for a trusted, caring professional to care for you beloved senior is understood. The search for someone to come to your home and treat your loved one the way you treat them can be...
ABRA ……Cares CARE FOR YOUR LOVED ONES When you need help at home with family members, let ABRA assist! ABRA specializes in helping your family members stay healthy at home. Many seniors can benefit directly...
We understand that the lives of seniors can be somewhat unpredictable, and dramatic changes can happen quickly and without warning. Norm and Marcia Harris opened Senior Helpers Vancouver to provide an uncompromising level...
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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.