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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
✔
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:
When we started LifeWorx in 2004, we wanted to build more than caring, empathetic care services. We wanted to build a community of giving. A place you join as an individual, ‘me’, but where you become part of a greater ‘we’. A place where we’re redefining success measured by leading a fulfilling life, not just the bottom line. Our happy clients are our catalyst.
E B Home Health Care Inc is a licensed and trusted home health care agency based in Florida, dedicated to providing compassionate personal care services in the comfort and privacy of each client’s home. Our mission is to enhance the health, independence, and quality of life of every individual we serve through personalized, patient-centered care.
Senior Helpers Fort Myers - Cape Coral is owned and operated by Manuel Chavez and his wife Wendy Del Salto. Both Manuel and Wendy bring a wealth of medical expertise and enthusiasm to the table that is not seen in most home care companies. The Fort Myers-based team is dedicated to providing compassionate, reliable care that helps seniors continue living in their own homes and provides their families with invaluable peace of mind.
In the last 10 years, Mind & Mobility Home Care has helped over 10,000 seniors remain independent in their homes. It shouldn’t cost a fortune to keep your loved one thriving at home, and with us, it doesn’t have to. All you have to do to help your loved one gain the independence they deserve without breaking the bank is schedule a no-pressure call with us today. Show Less
Angels Around You Home Care has a passion and desire to provide seniors and others who need non-medical assistance and care at home. We provide an option for our customers to remain independent, safe and comfortable in the privacy of their own homes. Our compassionate caregivers are highly trained to provide the support, assistance and care for our clients. Angels Around You Home Care emphasizes highly, trusted personalized home care and exceptional customer service to meet your needs.
Home Care Services In-home care is a great way to get the help you need. You may be a senior who needs assistance with daily living activities, so trust our caregivers to help with meal preparation or personal care. You may also be caring for your aging parent and just need someone to be with them while you run errands. Home care services are versatile, flexible, and customized for your comfort, peace of mind and well-being.
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 of life for both seniors and their families in every caregiving experience. If your family recognizes the value of aging in place as we do, you’ve come to the right place. Home Instead® Care Professionals provide compassionate and reliable home care services to help keep senio
Home Helpers of Fort Myers is dedicated to giving care the way you want to be cared for. We are locally owned, and customize our care services to fit your unique situation. We make sure your loved one is cared for in the happiness of their own home, and accommodate for the fact that the care they may need today might not be what they need in the future.
At Concierge Care Fort Myers FL, we believe home is where healing and comfort begin, and we are here to make every day safer, brighter, and more meaningful for those we serve.
As a locally owned and operated business, founded by a native of Punta Gorda, we understand the unique needs of our community. Our mission is to deliver the highest quality home care services that promote independence, dignity, and well-being for our clients.
Maria's Home Care Services offers non-medical support, delivering companionship, focus, and kindness. Our goal is to coach families in home care practices, providing ongoing advice to ensure comfort, peace, and independence for everyone.
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, and providing you or your loved one with personalized elderly care services (unskilled caregivers may be utilized only in cases where no personal care or hygiene assistance is needed).
Searching for in-home companion care in Southwest Florida, Look no further! Senior Home Companions offers and coordinates comprehensive, non-medical care services in the comfort of your own home, no matter where you call home. From a few hours a day to 24/7 care, our private pay in-home care services provide what you need when you need it.
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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.