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:
Home Instead can help with compassionate, home senior care services delivered right in your loved one's home. Whether a few hours a day or long-term care 24 hours a day, a CAREGiver can assist you. All CAREGivers are...
HomeCare Professionals - Main Office, CA is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Havencare, we believe true care creates a safe haven of comfort and dignity. Our dedicated caregivers deliver individualized assistance—from everyday routines to heartfelt companionship and specialized care—helping...
Care Indeed provides non-medical home care services to seniors: personal care, support with mobility, help with household chores, companionship, and transportation. We also send our trained and experienced caregivers,...
At Interim HealthCare of San Francisco, CA, we know how important it is to be in a comfortable, familiar environment. We all value our independence, however, sometimes the best way to maintain our autonomy, or preserve...
My Caregivers Inc is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care America Homecare Services is a trusted home care agency dedicated to providing high-quality, compassionate care for seniors and individuals with disabilities.
At Gentiva Personal Care, our Personal Home Care Assistance can assist with personal care, daily living necessities, and help around the home. If you or a loved one is struggling with prolonged illness, recovery from...
Senior care matters deeply here in the East Bay Area, where our senior population continues to grow and become more diverse. It's all about improving the lives of our older community members, ensuring their safety, and...
At Always Best Care, we believe it’s a good feeling to be included in our clients' lives. Subtle smiles and long talks, showing kindness and humor during difficult times, providing the right levels of care – these are the...
At Interim HealthCare of San Bruno, CA, we know how important it is to be in a comfortable, familiar environment. We all value our independence, however, sometimes the best way to maintain our autonomy, or preserve that...
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...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
We are a dedicated healthcare provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity. Based on...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Home care is a service that you can rely on when you need assistance in the comfort of your home. If you are struggling with old age, injury, or illness, this might be the right time for you to look for a caregiver who...
Incare Home Health Services SF is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Care ServicesHome care services allow seniors to remain in the comfort of their own home and community. We serve clients in their homes, assisted living communities, hospitals and nursing homes.Depending on the...
Herewith, Inc. is a Massachusetts-based company offering flexible senior care services. Their team of background-checked "Caregivers" assist older adults with a variety of tasks, including home help (light chores,...
Welcome to ChoiceCare – Providing care management and in-home care services. ChoiceCare is your one-stop solution for those difficult questions concerning the care of your older love one. If your time is precious and...
CareSimply is the best way for families to find and hire high quality, affordable home care. Use CareSimply’s online directory to find your perfect caregiver. Caregivers must pass a rigorous screening process that...
FAMILY CARE SF, INC. is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Herewith is a mobile and online platform for families to find, hire, and manage flexible, affordable in-home care for older adults. Unlike an agency, on Herewith there are no hourly minimums or subscriptions, you set your...
Herewith is a mobile and online platform for families to find, hire, and manage flexible, affordable in-home care for older adults. Unlike an agency, on Herewith there are no hourly minimums or subscriptions, you set your...
Care for Seniors - San Francisco is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Herewith, Inc. offers flexible, non-medical homecare services in West Virginia, connecting seniors with trusted, background-checked caregivers who assist with a variety of tasks. Clients can book one-time or ongoing...
Herewith, Inc. is a nationwide platform that connects families in Montana with experienced cargivers for non-medical in-home care. Their services include assistance with light housekeeping, companionship, errands, and...
Health At Home is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Herewith is a mobile and online platform for families to find, hire, and manage flexible, affordable in-home care for older adults. Unlike an agency, on Herewith there are no hourly minimums or subscriptions, you set your...
Herewith, Inc. offers personalized, non-medical homecare services in Maine, connecting seniors with trusted, background-checked caregivers who assist with various tasks. These services include light housekeeping,...
Herewith, Inc. Vermont is a nationwide platform connecting families with experienced, background-checked caregivers for non-medical in-home care, including in Vermont. Their services encompass assistance with light...
A Distinguished Senior In-Home Care Provider in the San-Francisco Bay area. ….who are we? Care Giver Staffing is committed to providing Senior in-home care assistance that goes beyond your expectations.To truly care...
Herewith, Inc. Iowa is a nationwide platform that connects families with experienced, background-checked caregivers for non-medical in-home care, including in Iowa. Their services encompass assistance with light...
DUPE - Herewith, Inc. - Missouri is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advocate Homecare is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allied Care Bay Area Home Care provide a wide range of non-medical personal care services to anyone in need of some assistance with the routine demands of daily life. Those benefiting from our services include seniors and...
Herewith, Inc. is a nationwide platform connecting families with experienced, background-checked caregivers for non-medical in-home care, including in Michigan. Their services encompass assistance with light housekeeping,...
Cherish Senior Care is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Herewith we understand it is difficult finding compassionate, dependable caregiver services. We believe that families want the best for their loved one - that’s why our program includes allowing the family to...
Herewith is a mobile and online platform for families to find, hire, and manage flexible, affordable in-home care for older adults. Unlike an agency, on Herewith there are no hourly minimums or subscriptions, you set your...
Herewith is a mobile and online platform for families to find, hire, and manage flexible, affordable in-home care for older adults. Unlike an agency, on Herewith there are no hourly minimums or subscriptions, you set your...
Built with love in San Francisco, New York and Miami, by a team that has experienced the pain of finding and managing care ourselves, we’re committed to delivering better health outcomes for seniors, and peace of mind to...
Care Indeed - San Francisco is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Care Agency with over 20 years experience serving seniors and those who wish to remain in their own homes. We are the caregiver's employer. This relieves you of additional payroll, taxes and insurance calculations....
It’s human nature to want to be independent and self-sufficient, but there are times in our lives when we need a helping hand. Are you a new parent and feeling overwhelmed? Are you recovering from an especially...
To preserve the dignity of our clients by ensuring an easy, personalized experience, from dedicated, passionate caregivers committed to helping others live a better life at home.
Caring is what we do. We provide the in-home care needed by any elder hoping to live a comfortable and safe life at home. We also offer specialized Alzheimer's care as well as Hospice and end of life care. All of our...
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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.