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:
Seniors Helping Seniors® In-Home Care Services matches seniors who need a hand with mature, active women and men who have a passion for helping others. Seniors Helping Seniors® in-home services was founded in 1998 with...
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
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 of Lawrenceville, GA is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Suncrest Home Health Of Georgia, Inc is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Guardian Home Care of Northeast Georgia is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Free In-Home Assessment Home Care & Skilled Nursing Serving 21 Counties in NEGA Since 2004 Locally Owned/Operated by RN We Improve People's Lives Interim understands how important it is for people to...
Your Extended Family When Family Can’t Be There At Home Helpers Home Care, we’re here to do exactly what our name says: help. We’re more than an in-home health care agency – we are your extended family when family can’t...
Caresouth Homecare Professionals is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
From short-term assistance after a hospital stay to long-term help with everyday tasks, and from highly specialized medical care to daily companionship, we’re here to help provide the individualized care your loved one...
A HELPING HAND HOME CARE, LLC is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Visiting Angels of Lake Lanier, GA is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
An affordable home care referral agency for Seniors by caregivers Caregivers For Seniors is a home care referral agency that offers short and long term care services to seniors in the comfort of their homes. We service 24...
United Home Care Of North Georgia is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Green's Private Home Care is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Southern Companions is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home of Gainesville, GA is a home care provider that services in Gainesville, GA. 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...
Bayada Nurses is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tugaloo Home Health Agency, an Amedisy Company is a home care provider that services in Gainesville, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We provide North Georgia senior care services throughout Hall County, Gwinnett County, Gainesville, Dawsonville, Suwanee, Braselton, Oakwood, Flowery Branch, Cumming and the surrounding area. Our expert caregivers assist...
621 Washington Street SW Suite B-1 Gainesville,GA 30501 770-535-3007 visit our website at www.rah-nega.com contact: Bill Youngblood, CNA, administrator/owner bill.youngblood@rah-nega.com Laura Greeson, CNA,...
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.