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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:
Fidelity Home Care is a trusted provider of compassionate, high-quality in-home care services for individuals in need of assistance with daily living activities. With a strong commitment to personalized care, Fidelity...
BrightStar Care of W. Montgomery Co. offers in-home care and medical staffing that goes above and beyond. We call it “A higher standard." Our Professional Care Team, led by a Registered Nurse Director of Nursing,...
Our vision is to be the leading home care agency known for transforming lives through compassionate, reliable, and personalized care that empowers every client to live with dignity and independence.
Right Now Home Care is a home care provider based in Philadelphia, Pennsylvania. We understand that every client has a different care plan they need for their individual lives. Our daily services include meal preparation,...
At BrightStar Care Greater Chester County, we believe that caring is more than just a job– it’s a way of life. That’s why our caregivers mean so much more to the people, families, and organizations they serve. BrightStar...
One You Love Homecare - Huntingdon Valley/Mainline, PA is a home care provider that services in Villanova, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
We are here to assist our clients to live more independently with a higher quality of life. Working directly with our clients in creating an individualize care plan. Most importantly we are delivering great passionate...
At Always United Care LLC, we believe every person deserves to age with comfort, dignity, and love. Our caregivers go beyond routine support—building meaningful relationships and providing peace of mind for families....
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...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
To be the most trusted and compassionate provider of home care services, empowering individuals to live with dignity, independence, and joy in the comfort of their own homes.
Neighborly Home Care provides a comprehensive range of personal care services to assist seniors or anyone who needs help with activities of daily living, in their home or residence. We understand that maintaining your...
At Pennydynamic Care at Home, our mission is to provide compassionate, personalized, and high-quality in-home care services that enhance the well-being and independence of our clients. We are dedicated to delivering care...
To be the most trusted and compassionate home care provider, enriching lives through personalized care, dignity, and unwavering support — helping every client live safely, independently, and with purpose in the comfort of...
At Newtown Caregiving Services, our mission is to provide compassionate and reliable home health care services to our clients. We strive to improve their quality of life and help them maintain independence in the comfort...
The entire professional care team at Amada Senior Care Philadelphia West Suburbs understands the importance of quality senior care that helps aging adults thrive and live safely and independently. Choosing the right home...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Villanova, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
At Options for Senior America, we believe aging should never mean giving up independence or dignity. Our Wayne, Pennsylvania team is dedicated to providing high-quality, personalized in-home care that allows seniors to...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Neighborly Home Care - Ardmore is a home care provider that services in Villanova, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HOME CHOICE COMPANION CARE PROVIDES OUTSTANDING NON MEDICAL COMPANION CARE TO SENIORS WHO WISH TO STAY IN THE COMFORT OF THEIR OWN HOME. OUR MAIN OFFICE IS IN COLLEGEVILLE PENNSYLVANIA HOWEVER WE HAVE NINE OTHER LOCATIONS...
Accessible Home Health Care is committed to providing the highest level of in-home care to improve the health, wellbeing, and comfort of families all over the country. Each Accessible Home Health Care location is...
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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.