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:
Senior Helpers of Central Houston is the premier provider of in-home senior care in the Houston area. Knowing your loved one is happy, safe and cared for is your priority … and ours too. Our wide range of services ensures...
At Careco - The Caregiving Company, we are committed to providing high-quality non-medical in-home care services tailored to the individual needs of each client. Our mission is rooted in compassion, respect, and...
The “We are CARE” philosophy is a commitment to our core values of being Compassionate, Accountable, Respectful, and Ethical. These values are incorporated into every interaction A Place At Home has with the families we...
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At Abbydot Homecare LLC, we prioritize the comfort and independence of our clients by offering professional and compassionate in-home care services. Our dedicated team provides personal care, companionship, and...
Delight Care Compassionate In-Home Care Services At Delight Care, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence. Our mission is to...
At Home Instead, our families live and work in Houston, so we're invested in our community on a very personal level. We offer friendly, responsive home care services right in your neighborhood. If you or a loved one could...
Since its inception, Cardinal Senior Care has been rapidly growing. Our Cardinal Senior Care management team brings to the company a diverse set of backgrounds with over 40 years of experience in service, hospitality,...
At Dieset Home Care Services, our mission is to provide compassionate, high-quality, and personalized care to individuals in the comfort and security of their own homes. We are dedicated to enhancing the quality of life...
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We are a senior home care service that allows your loved ones to stay where they feel most comfortable in Katy, Houston, and surrounding areas. Our trusted Katy staff can’t wait to meet your loved one. We want to know...
At Griswold Home Care of West Houston, we know how hard it can be to care for aging and/or disabled family members. With our assistance, you will not have to do everything alone. With empathy and compassion, our...
At Home Matters, we’ve made it our mission to provide high quality care for seniors that allow our clients to remain safe, comfortable, and independent at home. Our approach is unique, based on years of research in the...
Senior Helpers of North Houston advocates for high-quality senior care. We deliver customized, dependable, and affordable care to help provide a high quality life for our clients and their families.
At Gifted Hearts Home Health, we believe in care that comes from the heart. Our skilled and compassionate caregivers provide tailored in-home support, helping clients feel safe, supported, and empowered to live well in...
William Long, owner of Amada Senior Care Clear Lake, has made it his personal mission to help the seniors in our community live safer and more enjoyable lives. According to William, “I believe that each of our elders has...
Compassionate care and Extraordinary service. Receive comprehensive, empathetic care in the comfort and safety of your own home. As the oldest and largest personal home care provider in Texas, we have the experience and...
Acti-Kare is a leading in-home senior care company that has been trusted for over a decade. Our caregivers are insured, bonded, and trained which means you will receive a trusted and professional caregiver every time....
A Hug Away Healthcare, Inc. is not just a brick-and-mortar company; we are one of the best Female Owned healthcare agencies in Katy and Houston (Texas), with a comprehensive team of professional experts with over 35 years...
At T AND F Health Care Resources, we believe quality care starts with understanding and compassion. Our experienced caregivers provide respectful, individualized support to help clients stay safe, comfortable, and...
AVANTA CARE, LLC is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Aura Home Health LLC is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Care Committers Health Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Dorathy Caregivers LLC is a home care provider based in Richmond, TX 77407, offering a range of services designed to help seniors live comfortably and safely in their own homes.
Alina Healthcare LLC is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Continental Supports LLC is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
B & F Healthcare Services LLC is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ecedynamic Healthcare INC is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Life is Better with Villi of Houston, TX At Villi, we believe “It takes a village,” and we’re here to be that village for you and your loved ones. Our mission is to bring comfort, joy, and a helping hand to your daily...
Synergy HomeCare of Katy provides certified caregivers and personalized care for seniors living with cognitive or physical limitations. We are an affordable, compassionate and respected home care choice for families who...
We ensure optimal, comfortable, confident, and independent living for seniors and individuals with disabilities through personalized, meaningful home care. Our rock-solid team has your family's back every step of the way.
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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.