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.*
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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:
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Always Best Care combines national strength and standards with local accessibility and personal service. Your local Always Best Care team will be helping families throughout Roswell and Surrounding areas to provide...
With highly personalized care and a dedicated team of compassionate caregivers, you and your family can expect more from HomeWell Care Services in Lawrenceville, Gwinnett County and surrounding areas.
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Charlotte Web Private Home Care, LLC is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Priority Home Care, we understand that each individual has unique needs and preferences. That’s why we’re committed to providing personalized solutions tailored to you or your loved one. Our dedicated team of...
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...
Senior Helpers - North Metro Atlanta is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At HomeWell, we address the immediate needs of clients while anticipating future challenges to bolster and protect their well-being as they age. We are dedicated to the long-term effects of a masterfully-crafted care...
Infinity Homecare Service is a one of a kind home care program. Atlanta Homecare Specialist, Sharon, set out in 2010 to provide a top-notch home care service company with superior care and attention to details. Grounded...
Aspera Healthcare Services is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home is North Atlanta's trusted quality in-home senior care provider. We create custom care plans as needs change to allow your family members to live at home as long as possible.
When seeking a care service for seniors, those with disabilities, illness or recovering from injury or surgery, there are many factors to consider. You undoubtedly have many concerns and reservations. This is perfectly...
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At Family First Hospice Care, each person we serve receives kind, personal care. We go to any place our patients call “home.” Our proven care team approach meets patient needs and exceeds family expectations. If quality...
CarePoint Home Care is an Alpharetta based agency proudly serving residents within the metro Atlanta area. We provide non-medical private duty home care services specializing in companion and hands-on personal care...
A One Home Care is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AFFINITY CARES HOMECARE LLC is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Well Care Agency helps you or your loved ones to continue to enjoy a great quality of life at home. Our caregivers are hired based on their professionalism, enthusiasm, and compassion for seniors. We also make sure...
Angels Home Care Caring for Angels Home Care LLC will provide Personal Care services to individuals in their own homes and communities, who need assistance with their activities of daily living as a result of old age,...
ANGEL'S TOUCH LOVING CARE LLC is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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 a dedicated homecare provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity.
We help your loved ones live the best life possible, through our Personal Care Plus program. We offer holistic, personalized care that covers 8 areas: 1. Personal Care 2. Physical Fitness 3. Healthy...
Opulent Angels LLC is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a locally based home care agency serving seniors across the metro Atlanta area. Tapping into the knowledge, experience, tools and expertise established in over 20 years of managing Assisted Living communities,...
Guardian Angels Home Care provide health care services in a private home, assisted living facility, or adult family care home. Nursing visits Give medications or help the patient give themselves medications Physical,...
Trinity Quality Homecare is your family's trusted companion and leader in providing superior care and services for seniors, the disabled, and other individuals in need in the Atlanta Metro area. We are owned and operated...
Cindy's Elderly Care LLC - Alpharetta is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SYNERGY HomeCare of North Atlanta, GA is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Horizon Health Care Agency is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a private home care agency, supplying a full range of in home care services (personal care, respite care and companion care) to the senior and elder community of greater Atlanta. We offer these services both in...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Family Choice Healthcare is a licensed private homecare provider offering companion sitter, personal care support and nursing services to medically fragile and elderly individuals throughout Georgia.
BrightStar Care of Alpharetta, GA is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Prize Home Care LLC is a home care provider that services in Alpharetta, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
EASY LIVING SERVICES, INC is a home care provider that services in Alpharetta, GA. 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...
Castleton Home Care offers exceptional in-home care services for seniors and individuals with disabilities. Our professional caregivers provide support with daily activities, medical needs, and companionship, ensuring a...
It’s important what we do. It’s more important who we are. At Exclusive In Home Care we strive to provide a higher standard of home care with loving, compassionate trained individuals who truly care about family loved...
At Sarah's Angels In Home Care, we pride ourselves in delivering top-notch quality care for your loved ones. Each of Sarah’s Angels are driven by personal journeys traveling down the path of caring for others. Our mission...
Let Home Helpers of Alpharetta (Serving Cumming) Create a Customized Home Care Plan to Fit Your Lifestyle! Live life your way in the comfort of home with Home Helpers of Alpharetta. Whether you’re a family caregiver...
Home Helpers of Alpharetta can make your life easier by providing personalized home care for you or a loved one. We provide customized home care for seniors, new & expectant moms and anyone in need of recuperative care...
At Home Matters Caregiving of North Atlanta, we provide homecare that strives to keep our clients as independent as possible; improving quality of life, longevity and provide peace of mind.
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.