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:
Carescope offers a wide range of high quality non-medical care services, which have let the organization stand out among other services like our own. Our home health care services range from minimal companionship to...
Always Best Care Senior Services combines national strength and standards with local accessibility and personal service in Roseville, Granite Bay, Rocklin, El Dorado Hills, Carmichael, Orangevale, Fair Oaks, Folsom,...
Senior Helpers of Sacramento/Placer is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amevian Home Care you can count on finding and keeping reliable, high-quality care shouldn’t be difficult – but it often is. It all comes down to partnering with the right people. With our Sacramento caregivers and local...
Golden Years In-Home Senior Care is an innovative leader in the area of non-medical in home care. Our specialized care covers a wide range of services that relate to supporting and maintaining a happy healthy and safe...
Anytime Anywhere Senior Care: Non-Medical in-home support services for seniors or adults in need of assistance with activities of daily living. It is the goal of Anytime Anywhere Senior Care to provide affordable in...
Northern California Caregiving is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Live Well At Home By Eskaton - Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carol Pardue started Family Matters in 2002 and now, with her three sons, they have over 150 amazing care providers in San Francisco Bay Area and San Diego. All providers are employees and Family Matters is a licensed...
Family Matters In Home Care - Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
24 Hour Home Care - Roseville is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
Insta Care Services is a family-owned company built with compassion in helping and assisting others in need, turning their love and passion into a lifelong commitment. Insta Care is a product of years of expertise in...
SYNERGY HomeCare of Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Preferred Care at Home of Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sutter Visiting Nurse Association and Hospice is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It is our mission to provide quality, reliable compassionate and affordable care to our clients. We understand that the vulnerability of the frail, elderly, or disabled individual requires the presence of a caregiver who...
What can we do for you and your family? Right at Home understands your concerns when it comes to making big decisions regarding your family. For many people, our in-home senior care is the best solution for maintaining...
Golden Living Home Care is a reliable home care agency committed to providing exceptional, client-centered care to individuals in need of support. Our mission is to enhance the quality of life for seniors, individuals...
TheKey Corporate - Craig Cares, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentiva Health Services - Certified is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Maxim Healthcare Services, Inc is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Roseville / South Placer County, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Care To Stay Home - Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Choosing an in-home care provider can be challenging. Your priority is ensuring their safety, happiness, and well-being while enjoying the comfort of their home. That’s where we come in. We offer top-notch senior care...
Is it time to find a caregiver for your loved one? While this decision is never easy, choosing the right in-home care can profoundly enhance their quality of life. Homewatch CareGivers of Roseville is here to help ensure...
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 HomeWell of Roseville, we provide hourly at-home care for seniors and others who are struggling to manage day-to-day activities like grooming, bathing, cooking or even running errands. Our knowledgeable Care Managers...
Age Advantage specializes in meeting the needs of older adults by providing affordable, comprehensive, non-medical care in the comforts of home. Whether you are looking to maintain your own independence or if you are...
Home care has never been more convenient than with FirstLight Home Care. If you or an adult you love are in need of home care services, count on FirstLight to be there. Our friendly and highly trained staff offers home...
Carescope offers a wide range of high quality non-medical care services, which have let the organization stand out among other services like our own. Our home health care services range from minimal companionship to...
Always Best Care Senior Services combines national strength and standards with local accessibility and personal service in Roseville, Granite Bay, Rocklin, El Dorado Hills, Carmichael, Orangevale, Fair Oaks, Folsom,...
Senior Helpers of Sacramento/Placer is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amevian Home Care you can count on finding and keeping reliable, high-quality care shouldn’t be difficult – but it often is. It all comes down to partnering with the right people. With our Sacramento caregivers and local...
Golden Years In-Home Senior Care is an innovative leader in the area of non-medical in home care. Our specialized care covers a wide range of services that relate to supporting and maintaining a happy healthy and safe...
Anytime Anywhere Senior Care: Non-Medical in-home support services for seniors or adults in need of assistance with activities of daily living. It is the goal of Anytime Anywhere Senior Care to provide affordable in...
Northern California Caregiving is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Live Well At Home By Eskaton - Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carol Pardue started Family Matters in 2002 and now, with her three sons, they have over 150 amazing care providers in San Francisco Bay Area and San Diego. All providers are employees and Family Matters is a licensed...
Family Matters In Home Care - Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
24 Hour Home Care - Roseville is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
Insta Care Services is a family-owned company built with compassion in helping and assisting others in need, turning their love and passion into a lifelong commitment. Insta Care is a product of years of expertise in...
SYNERGY HomeCare of Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Preferred Care at Home of Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sutter Visiting Nurse Association and Hospice is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It is our mission to provide quality, reliable compassionate and affordable care to our clients. We understand that the vulnerability of the frail, elderly, or disabled individual requires the presence of a caregiver who...
What can we do for you and your family? Right at Home understands your concerns when it comes to making big decisions regarding your family. For many people, our in-home senior care is the best solution for maintaining...
Golden Living Home Care is a reliable home care agency committed to providing exceptional, client-centered care to individuals in need of support. Our mission is to enhance the quality of life for seniors, individuals...
TheKey Corporate - Craig Cares, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentiva Health Services - Certified is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Maxim Healthcare Services, Inc is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Roseville / South Placer County, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Care To Stay Home - Roseville, CA is a home care provider that services in Roseville, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Choosing an in-home care provider can be challenging. Your priority is ensuring their safety, happiness, and well-being while enjoying the comfort of their home. That’s where we come in. We offer top-notch senior care...
Is it time to find a caregiver for your loved one? While this decision is never easy, choosing the right in-home care can profoundly enhance their quality of life. Homewatch CareGivers of Roseville is here to help ensure...
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 HomeWell of Roseville, we provide hourly at-home care for seniors and others who are struggling to manage day-to-day activities like grooming, bathing, cooking or even running errands. Our knowledgeable Care Managers...
Age Advantage specializes in meeting the needs of older adults by providing affordable, comprehensive, non-medical care in the comforts of home. Whether you are looking to maintain your own independence or if you are...
Home care has never been more convenient than with FirstLight Home Care. If you or an adult you love are in need of home care services, count on FirstLight to be there. Our friendly and highly trained staff offers home...
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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.