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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:
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When the time comes that extra care is required, whether due to age or health condition, many people prefer the familiarity and comfort of their own home. At Homewatch CareGivers®, we believe that good care should not...
Stephen Conway opened Senior Helpers Fort Worth in 2013 due to his commitment to delivering the best possible in-home care to seniors in the Greater Fort Worth community. After winning a battle with cancer, Steve was...
Home Instead enables the elderly to live independently. It’s at home where quality of life is enhanced without the stress of interrupted routines and changes in daily habits. Our non-medical CAREGivers provide...
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...
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...
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 - Irving, TX is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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At Happier At Home - DFW, our mission is to provide compassionate and personalized home care services that empower individuals to maintain independence, dignity, and quality of life in the comfort of their own homes. We...
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...
Carepath Home Health Network is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Available Home Care Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Access Home Healthcare Services is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ABDI'S HEALTHCARE CORP is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aiding Home Health Llc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our caregivers deliver high-quality personal care with the sincere intention of preserving a secure and pleasant living environment for their charges. Our care team members take great delight in ensuring that your loved...
Encompass Home Health Of North Central Texas is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Doctors Home Healthcare Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Fulford Family Home Health is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are committed to providing high quality, client-centered and affordable Home Care services to our clients to assist them to lead dignified and independent lives in the comfort and safety of their own homes. Their...
Amedisys Home Health of Fort Worth is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cook Childrens Home Health is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Accolade Home Care is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Apg Homecare Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Divine Care Health Services is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Health Masters Homecare Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Finding caregivers who care. Champion Caregivers has been licensed by the State of Texas for over 2 years and provides non-medical companion/ homemaker services to seniors, those recovering from surgery, new and...
Encompass Home Health of North Central Texas is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bestcare Home Health Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Cornerstone Caregiving's Central Fort Worth office, we are committed to providing compassionate, personalized care that makes a real difference in the lives of our clients. Our team of dedicated caregivers is carefully...
Always Here For You Senior Care LLC of Fort Worth, TX is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Acti-Kare of Fort Worth, TX is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Grandcare Home Health Llc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Senior Service is a trusted homecare choice for seniors and their families in the area. Read more about our homecare services for this area. Caring Senior Service offers services, education and safety care...
Guardian Health Care is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our staff possess the knowledge, skills, and experience to provide quality services to individuals with complex needs. With degrees and education in social work, health care, and other related fields, our employees build...
EXCEPTIONAL HOME CARE INC is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ComForCare Home Care - Fort Worth, TX is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comfort Keepers of Fort Worth, TX is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Girling Health Care Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Compassionate Healthcare is a locally owned and operated, non-medical home healthcare company. It was started by mother and son, Cynthia and Justin Harris, after one of their family members became sick and needed...
Ccb Healthcare System is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AmeriCare Fort Worth offers a variety of in-home support services that care for your loved one’s mind, body and spirit. Our caregivers provide companionship, personal, respite and post-operative care – all in the comfort...
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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.