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.
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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:
Locally owned and operated by Wesley J. Holloway and Jeff Miller. Happy at Home is skilled home healthcare and is comprised of a team of highly skilled health care professionals providing Skilled Nursing, Physical...
We are an in-home personal and companion care agency that has helped families all over Dallas and surrounding areas. We have a Personal Assistance Services License issued by the Department of Aging and Disability Services...
If you’ve been searching for a home care agency for your care or your loved one’s care, then you know there is a sea of sameness in the dozens of home care choices, making it difficult to actually choose one. And we know...
Home care enables you or your loved one to continue living in the comfort of home with assistance from a qualified home care provider. We respect the many factors and careful thought that go into making decisions for the...
At Careco - The Caregiving Company, we are committed to providing high-quality non-medical in-home care services tailored to the individual needs of each client. Our mission is rooted in compassion, respect, and...
Reliable, personalized, in-home care In-home care shouldn’t have to be complicated. See if Embark is the right fit for you or your loved ones. What we do We provide personalized non-medical care including assistance...
Linak Health Services is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Fellowship Home Health Llc is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
New Concept Health Services Inc is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Med Team Div is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Rose City Home Health Services Inc is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Whether providing short-term assistance or long-term support, our team is committed to enhancing well-being and fostering peace of mind for both clients and their families.
Humility Home Health Services Inc is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Paradigm Rehab & Nursing is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care offers a wide variety of high-quality services—from in-home care to medical staffing. If you are looking for a trustworthy care provider or staffing partner in the Tyler & Longview, TX area, please contact...
Elect Home Health Care Inc is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home - Tyler, TX is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We offer: Quality Care We take great pride in being able to provide exceptional care while supporting and encouraging our clients to perform their daily tasks. Daily Assistance Our approach to care is to restore...
Encompass Home Health of East Texas is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Home Healthcare is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heritage Home Health is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allegiance Home Health Services is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home-Aid Care Givers is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Circle of Faith Caregivers is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Unicare Home Health Services is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Trinity Mother Frances Home Health Services is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Genesis Homecare is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Better Day's at Home Senior Care Service, your trusted partner in providing compassionate, non-medical in-home care for seniors in Tyler, Texas, and surrounding areas. Our mission is to enhance the quality of...
Graceland Agency LLC is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
U’Nique Home Care provides aid and companion care services to seniors mentally challenged and physically challenged adults. Through coordinated care and support for clients and their families, U’Nique Home Care enables...
Compassionate Home Health Care Inc is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Bethany Home Health is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
Tyler Home Care is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our comprehensive home care is customized for seniors based on their individual needs and preferences. Our dedicated and reliable caregivers have helped thousands of older adults live happily and safely in the comforts of...
Exceptional Home Care is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission at Virtuous Homecare is to provide professional and paraprofessional services to clients in their homes, assisting them to achieve the highest level of potential in their day-to-day self-care activities. We...
Morden Home Health Care Inc is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Omega Home Health is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Health Care Services I is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Unicare Home Health Services is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CHERISHED CONNECTIONS HOME CARE LLC is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Health Care Services is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nightingale Home Health Agency is a home care provider that services in Tyler, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
Our passion is helping those in need. Right at Home is dedicated to extending the independence of seniors as well as improving the quality of life for all those we serve. We provide caregivers to assist seniors in...
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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.