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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:
Our senior care services in Houston, TX help aging adults stay engaged in everyday life with tailor-made support to stay safe and well at home. It’s our mission to provide a care plan personalized to your family’s needs...
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...
We support seniors and their families by providing opportunities for meaningful engagement. Our caregivers building authentic, caring relationships and implement custom care plans that evolve with a senior’s needs.
FirstLight Home Care strives to be the industry leader of The Woodlands, Northwest Houston and Katy in home care, respite care, and senior care. We work hard to ensure we have the most skilled and trustworthy caregivers....
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Tomball or in surrounding areas.
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.
Happier at Home is the perfect solution for seniors that need support to maintain independence in their place of residence, no matter where they call home. We are dedicated to improving the lives of our clients by...
At Angels Over Us North LLC, we believe that every client deserves care delivered with compassion, dignity, and trust. Our experienced caregivers offer personalized assistance with daily activities, companionship, and...
Griswold Home Care was founded by the late Jean Griswold in 1982, making us the oldest non-medical home care franchise organization in the country. While we operate in a growing industry with many respected competitors,...
Christian based senior care service, located in the northwest houston area (Tomball), Tx, servicing All houston zipcodes, and surrounding areas. No destination out of reach. Our services are tailored to meet your needs...
Sienna Home Health Care is a home care provider that services in Tomball, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
FirstLight Home Care of Tomball, TX is a home care provider that services in Tomball, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When people come to know You’re First Care and experience the difference, they realize we are very different from other Home Care Agencies; this is by design. We work hard every day to bring the very best Care to...
At Caelum Home Healthcare Services, we understand the importance of phenomenal care for your loved ones. Our mission is to provide exceptional care that emphasizes independence, dignity, and increased quality of life.
Tomball Regional Hospital Home Health Services is a home care provider that services in Tomball, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
FirstLight Home Care, Extraordinary People, Exceptional Care. We help seniors and adults remain independent in their own homes or wherever they need help (whether it’s recovering from surgery, dementia care or...
Breakthrough Personal Homecare Services LLC is a home care provider that services in Tomball, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
G and V Health Services is a home care provider that services in Tomball, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nurse Next Door’s mission is to make lives better every day. It starts with a team of compassionate, dedicated, and caring staff who are passionate about making a difference. We always hear amazing stories from clients...
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...
Guided by a native Texan, Always Best Care ensures that exceptional service and care is provided to all family members. Caregivers are thoroughly screened, licensed, bonded and insured to provide the safest and highest...
Locally owned and operated, Synergy HomeCare of Northwest Houston has been awarded "Best of Home Care" for its expertise in providing quality Home Care services. Synergy HomeCare is dedicated to providing exceptional and...
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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.