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:
At Prestige Loving Home Care, we are committed to delivering exceptional service to your loved ones. With a dedication to personalized care, we ensure every client experiences comfort and peace in their home and lives an...
Gentle Home Personal Care in Indianapolis offers compassionate in-home assistance, tailored to each client's unique needs, ensuring comfort and independence. Our dedicated caregivers provide a nurturing environment,...
At Precise Home Care Agency, we believe care should be personal. Our skilled and compassionate team provides reliable in-home support—from help with daily routines to companionship and specialized care—empowering clients...
At Amada Senior Care of Greater Indianapolis, our goal is to walk with seniors and their loved ones through every step of their senior care journey. They are committed to preserving dignity and giving families the peace...
Sigma Personal Care LLC offers personalized in-home care services tailored to meet the needs of seniors and individuals requiring assistance. Our compassionate caregivers focus on promoting comfort, independence, and...
Companion Care The goal of companion care is primarily emotional support, socialization, caregiver assistance, light housekeeping, and companionship to help senior and elderly adults function independently in their own...
At Divine Care Solutions LLC, we are dedicated to providing compassionate, personalized home care services that promote dignity, independence, and peace of mind. Whether you or your loved one need assistance with daily...
Kind Hearts Caring Hands Homecare LLC is a trusted and compassionate home care agency dedicated to enhancing the quality of life for seniors and individuals with disabilities in the comfort of their own homes.
We’re always there when you need us – ready to provide care in all ways. When faced with the decision to provide care, you need a trusted partner. One who has the knowledge gained from years of providing quality home care...
Care When and Where It’s Needed Our home care services are available 24 hours a day, 7 days a week, 365 days a year, so you know your loved one’s needs are always being met. We offer care when and where it’s needed,...
Patient Hands strives to always remain personalable and relatable to the clients we serve. We strive to provide one on one care to make our clients activities of daily living as easy as possible. We like for our...
A-1 Personal Services Agency in Indianapolis, Indiana, is a licensed, Medicaid-certified home care provider offering personalized non-medical services like personal care, companionship, homemaking, and respite care....
Elroi Care Home LLC offers professional support services that allow individuals to live safely and comfortably in their homes regardless of age, physical, medical or emotional conditions.
We’re intentionally different. We set the benchmark for excellent home care by balancing our friendly nature, person-centered approach, and discreet services with our love of helping you maintain your independence. It’s...
At Vesta Structured Family Care, we extend beyond traditional care services; our foundation is built on compassion and a personalized approach to support. We are passionately focused on serving seniors, driven by a...
Golden Heart Senior Care offers the highest quality companion care, home care services and personal care services so our clients can live a full and independent life in the comfort of their home.
Obstacles of Life LLC provides compassionate and supportive in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily living, personal care, and emotional support,...
SYNERGY HomeCare of Northern Indianapolis is owned and operated by Trent Terry, a Master’s graduate in Business Administration who has since put his degree to use in multiple successful entrepreneurial ventures, ranging...
At Elevated Care with Compassion Inc., our mission is to provide exceptional, patient-centered healthcare that nurtures the whole person—mind, body, and spirit—through a seamless blend of professional expertise,...
Reassuring Love & Resilience Homecare is a dedicated home care provider based in Indianapolis, Indiana, committed to enhancing the quality of life for seniors and individuals requiring assistance with daily living activities.
Daily Care LLC is a compassionate and reliable service provider dedicated to enhancing the quality of life for individuals through personalized care solutions. Specializing in non-medical home care services, Daily Care...
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...
Helping Hands Senior living provides personal care and companionship for the elderly, Housekeeping, shopping, food preparation, and transportation are all tasks that we can assist with.
C AND R DIVINE HOME CARE LLC is a home care provider that services in Westfield, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Dominion Home Care LLC is a trusted and dedicated home care agency proudly serving the entire state of Indiana. Our foundation is built on the core values of compassion, respect, integrity, and excellence, which drive...
Arnette's Helping Hands LLC is a home care provider that services in Westfield, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ours is Pax-Ancora (Pax-Peace; Ancora- Anchor/Support) and we provide peaceful support that is personalized and tailored to your individual needs. Our dedicated team provides compassionate care, built on a foundation of...
Love and Care Home Services LLC is a non medical home care service agency located in Indianapolis IN. We offer Personal Assistance Services (PAS), Companionship, and More. We believe that Health is a state of complete...
CORNERSTONE CAREGIVING IN INDIANAPOLIS, INDIANA We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Indianapolis or in surrounding areas like...
Senior Helpers Indianapolis helps families navigate the full continuum of senior care. Our in-home aides allow seniors to receive the day-to-day help with personal care they need and assistance with activities of daily...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
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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.