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:
Paul Tobillo, owner of Amada Senior Care Cincinnati, has made it his personal mission to help the seniors in our community live safer and more enjoyable lives. Says Paul, “To care and to receive care are the most...
The Senior Helpers West Chester office was opened in 2018 to match the growing need for in-home senior care in the surrounding community. We offer a wide range of services from companion care to chronic disease care. We...
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...
We provide the highest quality home care services to people in need of assistance. Our dependable caregivers focus on personal care and support with activities of daily living, errands, light housekeeping, medication...
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead Senior Care® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance...
The challenges of having aging parents drew Chris Nieman to Senior Helpers as a life's work that he could be passionate about. His team is committed to delivering the best possible in-home care to seniors in the Northern...
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...
Client Care & Community Provide quality with every action. Clients first. Lead with others in mind. Tap into the brilliance of the community to generate ideas that will lead to improvements in the home care industry.
Constant Seniors Care LLC, based in Cincinnati, OH, offers personalized non-medical home care services to seniors. Focused on promoting independence, safety, and comfort, they provide compassionate assistance with daily...
We will deliver the highest quality clinical care to sustain the health and well-being of every resident. We will provide access to amenities and activities, and foster relationships that encourage fulfilling and...
"touching lives through personalized home health care" Caring Hearts has been locally owned and operating since 1988. We operate on the principle of teamwork with the main goal to offer the highest quality of service...
First Choice Home Health Ohio, Inc is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Community Home Care offers services to seniors in Cincinnati, Kentucky, and Dayton to enable them to remain in the comfort of a familiar environment. CHC is dedicated to the core values of combining quality care,...
Angels On Earth Home Care LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alternate Solutions Home Care of Cincinnati is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Affordable Assisting Angels LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Children's Hospital Home Health is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
How We Help We provide quality, affordable, non-medical in-home care for adults of all ages so that they can enjoy the best quality of life wherever and whenever they need it. Whether for seniors that need some...
At Your Service Because you value your independence and enjoy your home, we bring our special care to you. Non-medical in-home care improves your quality of life, gives you security and peace of mind, all in the privacy...
Care Connection of Cincinnati is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amedisys of Cincinnati is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alternative Home Care Staffing is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Delightful Hearts home Care, LLC is dedicated to providing exceptional, cost effective, family focused care for the medically complex patient. Our goal is to meet the patient's medical needs in the nurturing environment...
Comprehensive Health Care Services, Inc is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Better Solution In Home Care has been helping individuals and families with their care needs since 2000. We have a full service staff available 24 hours per day, 7 days per week. Our staff are experienced, professional,...
Absolute Healthcare Services is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BLESSING HOME HEALTH CARE INC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BUILT FOR LOVE HOME HEALTH SOLUTIONS is an Ohio based Company whose business is providing short and long-term healthcare personnel to facilities and homes. We also specialize in providing DODD and STNA training.
Welcome to Dakota Care, where we provide a wide range of non-medical home care services in Hamilton County Ohio, from respite care to Alzheimer's care. Whether you have an aging loved one who could use some company, a...
Cardinal Home Healthcare Solutions, Inc is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Best Choice Home Care is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cornerstone Caregiving offers senior home care that allows your loved ones to stay in the comfort of their own home! Our services include Greater Cincinnati area including: Hamilton, Butler, Warren and Clermont Counties....
A Loving Companion Home Care LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caregivers You Can Trust Feel better in the comfort of your own home. We specialize in care and daily living assistance to an array of individuals. Whether you need daily or weekly assistance due to aging, illness,...
Blessing Home Health Care, Inc. is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Always There Homecare is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Chambers Quality Care 24/7 Home Health Care Agency LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Billie's Angels Home Care LLC, based in Cincinnati, OH, offers compassionate non-medical home care services designed to enhance the quality of life and independence of its clients. With a focus on personalized care, they...
American Mercy Home Care, LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
GRACEFUL GOLDEN YEARS HOME CARE AGENCY is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caregivers Health Network is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
If seniors are struggling to remain in their homes we provide non-medical services to help them stay there. We have an excellent reputation that we earn - EVERYDAY.
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...
Acti-Kare of My Cincinnati provides quality in home care services to families and seniors in Fairfield, Glendale, Sharonville, Springdale, Edgemont, Indian Hill. Our carefully selected and qualified caregivers deliver...
At Caring and Compassionate Home Care LLC, we help seniors and older adults with non-medical activities of daily living. Care and companionship are available on an hourly or a live-in basis. We are the experts when it...
Our mission is to improve the quality of life for individuals by offering a secure, supportive, and friendly setting. We advocate for our members and work towards diminishing the negative perceptions associated with...
Quality caregivers and medical staffing solutions in Hamilton County At BrightStar Care of OH – Springdale, owned by John Heppler, our home care agency provides quality home care, caregivers, and medical staffing...
HomeWell Care Services of Cincinnati, OH is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Assisting Hands®, we offer the finest personalized, non-medical elder care services and senior in-home care services for families in Cincinnati and Northern Kentucky. Sometimes life’s natural events-aging, illness, or...
Family Bridges Home Care offers individuals and couples the opportunity to choose where they want to live. In-home assistance provides individuals with a sense of independence and comfort that can’t be found outside of...
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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.