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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.
✔
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:
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...
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...
Senior Helpers of Chattanooga was opened to address the growing need for in-home senior care in the Chattanooga community. We provide a variety of services and are committed to remaining at the forefront of the in-home...
Memorial Hospital Home Health is a home care provider that services in Chattanooga, TN. 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...
Caring Senior Service is a trusted homecare choice for seniors and their families. Read more about our homecare services for this area. Caring Senior Service offers services, education and safety care products that...
Maxim Healthcare Services is a home care provider that services in Chattanooga, TN. 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,...
Life Care at Home of Tenn is a home care provider that services in Chattanooga, TN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We provide professional health care and companion services that ensure all individuals under our care are treated with dignity and respect. An overview of our services and what makes Complete Care Choice different from...
CareAssist, a local leader in non-medical home care, provides cost-effective options to individuals desiring to remain independently in their own home. Service plans are designed to meet the client's personalized...
At Comprehensive Care, we select only top-quality caregivers through our intensive screening and training process. Learn more about our team of expert caregivers today. We have a proven history of finding the perfect...
Preferred Care at Home is dedicated to providing reliable, compassionate and affordable care to the Chattanooga community. The care we provide improves quality of life while safeguarding independence and dignity in the...
A Caregiver / Aide to care for your elderly at your home for trusted & dependable non-medical home assistance, bathing, medication reminders, meals, light housekeeping, laundry & companionship. Available 24 hours / 7 days...
Our GreatCare® method addresses the three most important areas of concern; quality caregivers, care solutions and active involvement. For over 25 years, Caring Senior Service has set the standard for senior home care...
Riverdale Health Group LLC. is committed to giving you the best care for your loved ones. We take pride in our supportive service care experience with our client. The first step to meeting our clients needs starts with...
Southern Care Staffing is a home care provider that services in Chattanooga, TN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentiva Health Svs Chattanooga is a home care provider that services in Chattanooga, TN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Synergy Homecare of Chattanooga, TN is a home care provider that services in Chattanooga, TN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amedisys Home Health Chattanooga is a home care provider that services in Chattanooga, TN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Live Oak Caregivers is NOT a franchise. We are an experienced, family-run organization that has completed over one million hours of caregiving service to the elderly and those in need. We assign a case manager to every...
Assisting Hands exemplifies compassion, dependability and dignity to all of our clients. Our company was founded on the principles of caring for others in a way that we would also want to be cared for which is made...
Family Home Care Inc is a home care provider that services in Chattanooga, TN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Chris Ray, owner of Amada Senior Care of Chattanooga, views his role as part of a larger commitment to our population of cherished seniors in Greater Chattanooga and surrounding areas. Chris believes that our beloved...
Continucare Healthservices, IN is a home care provider that services in Chattanooga, TN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Chattanooga, TN is a home care provider that services in Chattanooga, TN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amara Home Care is a home care provider that services in Chattanooga, TN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comprehensive Care is a true one-stop-shop resource by providing care navigation, personal care services, and community placement guidance. We recruit top-quality caregivers and retain them by investing in higher pay and...
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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.