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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'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...
Gentiva Personal Care - Campbell, CA is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Assisting Hands of Fremont CA is a home care provider based in Newark, CA and serves Alameda County. Whether it’s help with daily activities, personal care, safety concerns due to cognitive decline, or the desire to...
At AmeriCare, we work hard to find caregivers who love what they do and recognize the impact they have in their client's lives. We understand the importance of finding people who can be trusted and we work together as a...
Thrive Home Care - San Leandro is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Indeed provides non-medical home care services to seniors: personal care, support with mobility, help with household chores, companionship, and transportation. We also send our trained and experienced caregivers,...
Since 2002, Senior Helpers has been a national leader in professional in-home care services. With a vision to help seniors remain in their homes despite age-related changes and chronic medical conditions, we have now...
Welcome to Med Staffing LLC, a locally owned health care staffing agency serving the Bay Area since 2001. We are committed to providing our clients with qualified health care staff. Through our years of experience, we...
We at Kingdom Hope understand the challenges our families face when caring for a loved one. Whenever life’s difficulties hinder you from achieving wellness, then we are here to provide you with the best non-medical home...
Managed Care At Home is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Horizon Home Health Care is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home care is a service that you can rely on when you need assistance in the comfort of your home. If you are struggling with old age, injury, or illness, this might be the right time for you to look for a caregiver who...
Nursing Resources is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Instead - Fremont, CA is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Professional Home Care Associates is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Noble Hospice & Home Health Care, Inc is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Over the last 6 years, Alondra Home Care has grown to become one of California’s most reliable providers of home care services. Our commitment to care has grown to not only Fremont, but also Alameda County, San Jose, the...
Home Helpers Home Care of Fremont, CA is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Warm Springs Home Health, Inc is a home care provider that services in Fremont, CA. 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...
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,...
American Home Health Care, Llc is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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, recovery, or rehabilitation,...
Happier At Home - Fremont, CA is a home care provider that services in Fremont, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allied Care Bay Area is a non-medical in-home care provider. We offer the very best, compassionate care for the adults and elderly. It is our goal to improve the physical, emotional and spiritual wellness of our clients,...
At SYNERGY HomeCare, we build connections and forward momentum in people’s lives. We call it the Synergy Effect. We believe our purpose is to provide the best care possible. Equally important is helping people feel, see...
At Home Helpers Home Care of Fremont & Union City, our primary goal is to deliver trusted and affordable in-home care solutions that will keep your loved one happy at home. We take great pride in providing expert care...
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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.