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:
Genesis Homecare Services believes that everyone, especially our seniors, deserves joy and comfort in their lives. Our unique business combines the delight of sweet treats with a commitment to providing exceptional senior...
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Care Pros at Home is the most reliable and trustworthy Home Health Care Service service in Oakland, and Genesee counties — providing excellent home care solutions to loved ones who are dealing with injury or illness. We...
Miracle Home Care LLC is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We’re here to help you continue living independently. If you or a loved one is having trouble with activities of daily living, home safety or personal care, we can provide a specialized program to make life easier and...
Acti-Kare is a leading in-home senior care company that has been trusted for over a decade. Our caregivers are insured, bonded, and trained which means you will receive a trusted and professional caregiver every time....
Zenith Home Care is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Progress At Home, L L C is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Precision Home Health Care, Inc is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advocate Home Care Inc is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
New Passion Home Care, L L C is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With Love Homecare, Inc is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Best Health Home Care System, L L C is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aquarius Home Care, L L C is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Great Lakes Home Health Care, L L C is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Elite Home Health Care, Inc is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Njoy Senior Services LLC is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Health Producers Home Care Agency, Inc is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Pure Hearts Home Care, LLC is a reliable home care agency committed to providing exceptional, client-centered care to individuals in need of support. Our mission is to enhance the quality of life for seniors, individuals...
Reflex Home Care, L L C is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Safe and Secure Home Health Care.LLC is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
American Community Home Care Services, Inc is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Trinity Homecare is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Mobility Plus Home Health Care is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
If you or your loved one require help doing everyday tasks, contact or visit the adult services unit at Bay of Bengal Homecare Service. The Home Help program is meant to enable adults who desire to remain free in their...
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Our vision is to be the leading provider of compassionate and innovative home care services in Michigan, setting the standard for quality, integrity, and personalized care. We aspire to empower individuals to age...
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Lifelink Home Health Care Services, Inc is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Crystal Waters Home Care Services is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amedisys Home Health of Warren is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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East West Health Services is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
First Care Integrated Health Services, Inc is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Activ-Care Home Health Services, Inc is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Discover personalized and affordable care services at Avalon Essential Home Care in Troy, Michigan. We prioritize understanding your loved ones’ needs to provide quality care with the right caregivers.
Comfort Care Home Care Assistance - Grosse Pointe is a home care provider that services in Warren, MI. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Proactive Home Care, we believe in going beyond basic care. Our compassionate caregivers are dedicated to enhancing the everyday lives of seniors. Whether it’s providing assistance with daily activities or offering...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Royal Oak or in surrounding areas like Troy, Bloomfield Hills and Grosse Pointe.
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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.