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:
Licensed for Hands on Care and Companion Services Fully Insured Licensed by the Department of Health and Human Services Division of Health Services Regulation Covering 14 counties out the Raleigh office: Wake, Alamance,...
Eagle Healthcare Services, Inc, located in Raleigh, NC, provides comprehensive healthcare services designed to meet the diverse needs of individuals in the community. Their services include personalized care solutions...
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...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Our Mission Our mission is to improve our clients’ lives and health by providing professional services, enabling them to achieve the full potential of every day. Our Caregivers We ensure our caregivers are highly...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Home Instead has been serving Tarheel families for over a decade. We provide the extra help that is sometimes needed so that seniors may continue to live as safely and independently as possible.
Senior Care in Durham, NC is a lifestyle. Our professional team come from the fields of geriatric and nursing care or are nurses, certified nurse assistants, certified nurses and domestic helpers. All are well trained...
Discover Cherished Non-Medical Homecare, where we prioritize the well-being and happiness of your loved ones. With our compassionate and dedicated team, we provide exceptional care that brings comfort, joy, and peace of...
Did you know that personal care services from Aryzen Health & Wellness can make your home health episodes more profitable, improve the likelihood of return patients, and improve the frequency of return patients? Here’s...
Inspired Home Healthcare Services, LLC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Angels Home Care Services, Inc. is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors Helping Seniors - Durham and Chapel Hill, NC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Pleasant Health Agency, we help seniors and older adults with non-medical activities of daily living including meal preparation, assistance with bathing, dressing, toileting, light housekeeping, medication reminders,...
Pacific Health Care Services, Inc. is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mary's Amazen Homecare, LLC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Innovative Senior Care Home Health is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Recovery Healthcare Agency is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tar Heel Home Health is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Absolute Home Care Agency, LLC, NC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hands From Heaven, LLC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carrington Home Care, LLC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Souls Home Health, Inc. is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Whether a family member needs a little extra help around the house, assistance recovering from a hospital stay or someone to check in on them throughout the week, Right at Home Durham & Chapel Hill's in-home care is the...
Located in Durham, North Carolina, Tower of Blessing Home Care Agency is dedicated to providing compassionate and personalized home care services to individuals in need. Our team of experienced caregivers is committed to...
Stand-Out Stand-In Specialist is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mercy's Home Care Agency-Durham-NC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
As your caregiving partner of choice, we aim to provide responsive and excellent client-centered healthcare services designed to meet the needs of our clients. Seeing you go about your day free from pain and worries with...
Albertacare - Durham, NC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amedisys Home Health is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Here at Infinity 7even Homecare, our compassionate and highly trained team of caregivers are proud to provide families throughout Durham, NC, and surrounding areas with exceptional at-home care services second only to the...
Welcome to Active At Home Senior Services. We are excited to show you all that we have to offer! Our goal is to enrich the lives of older adults in our community through a variety of personalized services designed to...
Health Care Options of the Triangle, Inc is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DUPE - Recovery Healthcare Agency is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mount Zion Home Health Care, Inc. is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Morgans Care, LLC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentiva Health Services is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Love Has Come Homecare LLC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When it comes to compassionate and all-inclusive homecare services in Charlotte, Durham, North Carolina, and the surrounding areas, Exceptional Service HomeCare Agency, LLC is your reliable partner. We stand apart because...
CareSource, LLC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Beautiful Remissions, LLC-Durham-NC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right Time is a provider of home care and staffing services with many years of experience and dedication to enhancing quality of life for others. We are proud of our compassionate home care program designed to help people...
Ole Creek Health and Wellness Inc is a home care provider that services in Durham, NC. 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...
Options For Senior America - Cary is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
First Watch Homecare LLC is a home care provider that services in Durham, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Services -Companion Care For our basic level of care, caregivers provide services such as companionship, meal planning and preparation, light housekeeping, laundry, medication reminders, and other general assistance....
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...
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.