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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:
Feel better in the comfort of your own home. We specialize in care and daily living assistance to an array of individuals. Whether you need daily or weekly assistance due to aging, illness, recovery, or rehabilitation,...
Hearts of Love Caregivers helps families with non-medical in home care. We offer in home health care in select locations. With Hearts of Love Caregivers, every client receives extra ordinary care from our caring team. We...
Home Instead® is serving the Central and North Atlanta community by providing safe and compassionate in-home care. Their passion and goal is to enrich the lives of Atlanta seniors and their families.
Would you or a loved one benefit from in-home senior care in Duluth? If so, please contact us at Amada Senior Care in Duluth for a Free Care Needs Consultation. We specialize in providing comprehensive, non-medical,...
Bloom Rock Care was founded with a passion for providing high quality in-home care services to seniors and individuals with disabilities. Our founders recognized the need for personalized, compassionate care that is...
Cornerstone Caregiving is a senior home care provider in East Atlanta, GA that is trained and ready to help your loved one today. Our leadership team holds decades of at-home senior care expertise in the home care...
At Hopeful Haven Home Care, LLC, our mission is to provide compassionate, high-quality home care services that enhance the dignity, independence, and well-being of every client we serve. We are committed to delivering...
You can be confident that all of our caregivers are State licensed Certified Nursing Assistants, well trained in the diseases of the elderly, highly experienced in critical areas of need and have passed a complex...
Just as growing older can allow for a more relaxed lifestyle, it can also present new obstacles and challenges. Our clients have peace of mind knowing that we are dedicated to their satisfaction and quality of life. We...
Right at Home is North Atlanta's trusted quality in-home senior care provider. We create custom care plans as needs change to allow your family members to live at home as long as possible.
We know you have countless choices when it comes to selecting your care provider. At Esther Home Care, when we say, “Serving Families Is Our Pleasure,” we mean it. You are at the heart of our service! We respect and take...
Charlotte Web Private Home Care, LLC is a home care provider that services in Tucker, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
It is with pride that we provide you with experienced and capable staff at Divine Home Care & Staffing Agency. For years, we’ve assembled an efficient team that brings first-rate health services to your homes in...
Express Professional Homecare LLC is a home care provider that services in Tucker, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Central Home Health Care, an Amedisys Company is a home care provider that services in Tucker, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BELLE Ã?ME PCS, LLC is a home care provider that services in Tucker, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Azalea Home Care is a local and privately owned home care company providing care to the greater Atlanta area. Our services include Personal Care, Post Surgical Care (Knee/Hip Replacement, Back Surgery, Cosmetic Surgery),...
Hand-n-Hand is a Georgia based private home care agency providing quality personal assistance for elderly and disabled clients, 7 days a week, 24 hours a day. Our staff consists of sitters, therapists, companions,...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
Axess Health Solutions, LLC is a home care provider that services in Tucker, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Atlanta Healthcare Solutions Inc. is a home care provider that services in Tucker, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AZ Health Care Services provides compassionate, high-quality in-home support with a focus on personal care—delivering dignity, comfort, and peace of mind to families.
Access Home Care LLC is a home care provider that services in Tucker, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
APPLIED HOME CARE, INC of Tucker, GA is a home care provider that services in Tucker, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
LIVE WELL HOME CARE, LLC is a home care provider that services in Tucker, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Mission Our mission is to enhance the well-being of our clients by delivering the highest standard of personalized, home-based health care. We strive to create a supportive environment where clients can feel safe,...
FirstLight Home Care delivers loving and compassionate care to seniors in Atlanta in the comfort of their own home. Our team's "Culture of Care" helps people age independently with confidence, dignity and happiness.
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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.