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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.
✔
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:
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Amita Dhingra, owner of Amada Senior Care Cupertino views her role as part of a larger commitment to our population of cherished seniors in Campbell, Cupertino, San Jose, Santa Clara, and Saratoga. Amita understands the...
AmeriCare’s offices have served families in communities all over the country for more than a decade with genuine care and concern. Our professionals are passionate and personal about their work because they strive to make...
We support people to do the extraordinary everyday. ReachPoint Home Care is a local provider of home care and staffing services with over 10 years of experience and dedication to enhancing quality of life for...
At-Home care comes in a variety of offerings to meet the needs of complex family schedules. The average care ranges from 4 to 12 hours stays that are separated into day and night time care.
WelbeHealth is a Program of All-Inclusive Care for the Elderly (PACE), full-service healthcare provider that helps you live your life healthy and happy, in your own home.
As your personal caregivers, we relate to the opportunities and challenges of aging. Your days should be filled with ease and joy! That’s why our entire San Jose team is committed to empowering seniors, helping them...
Serving and supporting the communities of the Peninsula and South Bay (San Francisco Bay Area) At SYNERGY HomeCare we believe that everyone deserves the opportunity to live a purposeful, connected, and healthy life. We...
When it's time to find home care in San Jose for a beloved family member, choosing the right caregiver is crucial. Compassionate, professional care can make all the difference in ensuring your loved one's well-being and...
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...
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California Seniors Care (CSC) was founded by Del and Mercy Broberg in 2002 after owning and operating several care facilities for the elderly in San Jose, CA. Over 20 years after running the care homes, CSC was founded to...
At Griswold, care is personal, and we’ll work with you to create a care plan that best meets your needs, including companionship, homemaking, and personal care. We support those with certain conditions, illnesses, or...
Our dedicated team provides heartfelt care, ensuring every senior feels valued and supported. Every individual is unique, so is our care. We tailor support to fit every senior's needs and lifestyle. Comfort and security...
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...
Nu Care is the perfect solution for seniors and others in need who are not ready to leave their home for an institutional setting, but need support to remain at home. We improve your life by providing compassionate,...
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,...
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
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...
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
Arcadia Home Care - Campbell, CA is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nurse Next Door - Santa Clara, CA is a home care provider that services over 40+ zip codes across Santa Clara County. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Care Indeed Homecare Services are designed to meet the needs of families requiring personalized homecare for loved ones from qualified non-medical or medical caregivers as required. In addition to age-related issues,...
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Stephancharles Endeavors, Inc. is a state-certified personal care agency that provides Non-Medical assistance to Activities of Daily Living (ADL), supportive care and companionship services to support independence,...
Prohealth Home Care, Inc is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Pacific Home Health is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentiva Health Services is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Local, family-owned and operated, Familiar Surroundings Home Care was built on a philosophy that quality care begins with a trusted relationship between our clients and our company. Providing in-home care for people of...
duplicate - Home Helpers Home Care of San Jose, CA - oob - 1 is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Joshua Cares is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Royal Providence is a 3rd generation, family owned elderly care company with over 20 years of industry experience. Branching out to the Silicon Valley from Hawaii in 2011, Royal Providence is raising the standards of...
Mother's Nest Home Care is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With over 40 years in healthcare, the Companion Access Care (CAC) team provides services to seniors, and physically challenged adults. Because every moment counts in people’s lives, CAC ensures that our clients receive...
California Seniors Care is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mamlakah In-Home Care is a growing, family-run caregiving company that has served the Bay Area for over 20 years. We treat each and every client as a part of our family, giving them the warm, compassionate, and respectful...
Alegre Home Care is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When seeking a care service for seniors, those with disabilities, illness or recovering from injury or surgery, there are many factors to consider. You undoubtedly have many concerns and reservations. This is perfectly...
HOME CARE NETWORK was created to serve the changing needs of our society while maintaining the traditional values of the home and family. In recent years we have witnessed an increase of women in the work force, more...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
At Home Helpers Home Care, we’re here to do exactly what our name says: help. We’re more than an in-home health care agency – we’re your extended family when family can’t be there. From our initial free in-home...
Cloverleaf Care is a home care provider that services in San Jose, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
There is an incredible demand in our society for care professionals, and we are proud to be up to the task. And it's not just for seniors — if a member of your family needs help, we're the place to call. As we are a...
Absolute Senior Solutions is a home care provider that services San Jose, CA 95117. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
For over 15 years, Senior Helpers has been there to help anyway we can -- no matter how big or how small the task. Our owners, Shad Schidel and Alay Yajnik, know personally what it's like for the people in need of care...
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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.