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:
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Your Home Instead team in Owasso, OK possesses a heartfelt desire to work with seniors in the community. It is our ultimate goal to forge extraordinary relationships between our clients and their CAREGivers. When you...
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...
The owners of Amada Senior Care Tulsa are seeing the realization of a longtime dream serving as an advocate for seniors who want to live safely and independently with the support they need to maintain their health and...
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Evergreen Home Health, L L C is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Birth and Beyond Care LLC is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Shanadoa Home Health, Inc. is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HOME HELPERS HOME CARE OF SOUTH TULSA Home Helpers Home Care of South Tulsa is more than an in-home health care agency – we’re your extended family when family can’t be there. We’re a locally owned, trusted provider of...
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,...
We are more than an in-home health care agency: we are your extended family when family cannot be there. We are a locally owned, trusted provider of quality, compassionate in-home care, and we customize our home care...
Empowering Independence, Enriching Lives: Home Healthcare for U, LLC is dedicated to providing compassionate, personalized, and professional home healthcare services. Our mission is to enhance the quality of life for our...
Mashovin Home Health Care, Inc is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Saint Francis Home Health is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Oxford Healthcare is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Dream Caregivers Services, Compassionate In-Home Care Services At Dream Caregivers Services, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
At Oklahoma Community Caregivers, we'll provide you with peace of mind for the safety and care of the one you love. We specialize in providing excellent care to all patients and residents. Whether it's meal...
Reliant Home Health is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Excell's Personal Care provides personal service and assistance that make life easier and more enjoyable for those who need non-medical assistance at home or in their place of residence, and who have a desire to maintain...
At Devine Home Health Care Solutions, we understand that seniors, and others who need care and support, enjoy an improved quality-of-life when they continue living in a familiar surrounding – at home. That’s why we’ve...
Encompass Home Health of Northeast Oklahoma is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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The A-Team is a group of family members that run a privately owned, non-medical, healthcare service. The launch of our business came from the heart: to launch a Sitter and Companion establishment that bloomed from...
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Team Select Home Care is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Caring is a calling, not a job. It’s a desire that drives us to provide for your peace of mind and your loved one’s well-being. We can’t do one without the other. At InCare, we’ll step in and be there when you aren’t...
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Whether you need in-home support a few hours per week or multiple hours every day, U Got A Friend can help. Whether you want in-home aide services for a week or from now on, we'll be at your side. We serve you on the...
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Image Home Care is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
Bonny Crest Home Healthcare, Inc is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Millennium Home Health Care is a home care provider that services in Tulsa, OK. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amazing Grace Home Care offers in home senior assistance for those who would like to age in the comfort of their own home. With our optional video monitor, clients can watch their loved ones and keep a close eye on the...
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Welcome to the Griswold Home Care Tulsa Office. We are very proud to offer affordable, high quality home care to our community! Griswold Home Care has been delivering exceptional service for over 30 years through...
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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.