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:
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Mesquite. Our trusted Mesquite staff can’t wait to meet your loved one. We want to know how many...
Most individuals with chronic health issues, injuries, and disabilities prefer to receive the level of medical care they need in the most familiar and comforting environment – home. As a trusted care provider in Texas,...
Lone Star Visiting Caregivers is a Texas-based home care agency that prides ourselves on our carefully selected, trained caregivers who prioritize empathy and connection, ensuring clients receive reliable and respectful...
Eric vanGoethem, Owner of Amada Senior Care Dallas, has made it his mission to help seniors live safely and comfortably for as long as they can in the comfort of their own homes. Eric deeply empathizes with families who...
Senior Helpers connects caring, professional caregivers with seniors when assistance is needed so they can remain where they are most comfortable. We offer a wide range of personal and companion care services to assist...
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'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...
Home Care Book is a home care provider in Dallas-Fort Worth TX founded by professionals with national experience in healthcare. After reviewing countless home care and healthcare delivery models, Home Care Book was...
Senior Helpers of Grapevine Lake, Tx is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. In select markets we've also added skilled home care for clients that suffer from illness...
Our mission at Home Care Assistance is to change the way the world ages. We provide older adults with quality care that enable them to live happier, healthier lives at home. Our services are distinguished by the caliber...
Trusted care means peace of mind. Taking that first step in finding a home care provider can be a stressful decision. With HomeWell Care Services, you know you’re making the right decision.
We understand that home care needs extend beyond the traditional work hours of 9 to 5. That's why our North Dallas team is available 24/7 to address any questions or concerns that you might have. Reach out to us any time...
Our path is simple- to make a difference to our clients while helping them achieve their best selves, providing best possible individualized care from people who truly care. We understand life has lots of journeys and...
Oliver Araiza, owner of Senior Helpers East Dallas, Garland knows getting the best care for your loved one should not be difficult. Oliver is dedicated to his community and supports elderly clients by offing them a better...
Our mission at Ambience In-Home Care is to ensure seniors maintain happy and healthy lives in the golden years. We provide older adults with high-quality home care in Richardson that enables them to continue living at...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
Senior Helpers - Irving, TX is a home care provider that services in Dallas, TX. 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,...
AT HOME PERSONAL CARE, a premier provider of companionship non medical services to seniors now offers skilled services covered by Medicare, through their sister company, AT HOME NURSING CARE. Services such as Nursing,...
Assisting Hands Home Care provides professional non-medical home health care services, allowing our clients to remain safely and comfortably in their own homes.
1Personal Assistance Services is a well-known provider of reliable non-medical care services in the community of Dallas/Forthworth Metroplex, Collins County, and its surrounding areas. With years of experience and...
Assisting Hands Home Care® grew out of a desire to provide seniors, and others needing non-medical assistance at home, with the option that most people prefer – to remain independent, safe and comfortable in their own...
1st Mellinium Home Health Services Inc is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alpine Plus Home Health Care is a home care provider that services in Dallas, TX. 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 of Dallas, TX is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AAA Home Health Care Agency is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aline Home Health Care of Texas is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amedisys Home Health of Dallas is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advocate Home Healthcare Services Inc is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Good Homehealth is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We’re a family-owned franchise boutique located in the heart of the North Dallas Area. We believe it’s time the in-home care experience became more personalized, positive, and powerful. We bring our own family’s...
Alliancecare is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Anchor Home Health Services Inc is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Arise Home Health is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amazing & Blessed Home Health Services is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aria Home Health Inc is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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'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...
Visiting Angels - Richardson, TX is a home care provider that services in Dallas, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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'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...
At Acappella we understand is it hard to accept help from the outside. Our mission is to eliminate this fear and reduce stress by providing exceptional care to you or your loved one when it is needed the most. Our...
Since 2008, 24 Hour Home Care has become the fastest growing company in Texas because of our unique approach to in-home care. As a resource and support for you and your loved one we are committed to compassionate care....
Good Lyfe Care LLC is a standout personal care agency based in Garland, Texas, renowned for its exceptional commitment to client well-being and personalized care. The agency excels in providing a warm, compassionate...
Artwing Healthcare Solutions is a licensed non-medical staffing agency, providing the highest quality and compassionate personalized in-home care for our clients in all counties across the Dallas Metroplex, NorthTexas,...
Senior Helpers of Richardson offers companion care, personal care, and chronic disease care to seniors in the Greater Dallas area. We help you to decide what care service is best for your loved one and family 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.