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:
Here at Quality comfort we provide personal care, such as getting in and out of bed, walking, bathing, and dressing. We offer personal care services can provide aides that also help remind you to take your medicines, do...
At Empathy Senior Care in Metro Atlanta, our goal is to become an extension of your family unit, enabling your loved one to stay at home and independent for longer. Our dedicated home care team can be there for your...
Care When and Where It’s Needed Our home care services are available 24 hours a day, 7 days a week, 365 days a year, so you know your loved one’s needs are always being met. We offer care when and where it’s needed,...
CJ Homecare LLC is a trusted provider of non-medical in-home care services, dedicated to improving the quality of life for seniors and individuals with disabilities or chronic conditions. Our compassionate caregivers...
At Dependable Living, we are committed to empowering individuals to lead vibrant, secure, and fulfilling lives. Our mission is to provide unparalleled support and resources that enable our clients to navigate the...
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...
ComForcare Home Care is a non-medical home care agency located in Carmel, Indiana providing services in clients' homes and various facilities. No services are provided at the office.
Golden Heart Senior Care offers the highest quality companion care, home care services and personal care services so our clients can live a full and independent life in the comfort of their home.
Loving Care Home Solutions LLC is dedicated to providing compassionate, high-quality in-home care services tailored to the unique needs of each individual.
At A Loving Hands Family Care LLC, we understand the importance of compassionate and personalized care for your family members. Our mission is to provide exceptional non-medical in-home care services to clients in...
We Care at Home provides compassionate home care services that meet the needs of our clients and their families, by listening, planning, educating, and delivering the highest quality of individualized care. Our dedicated...
We’re always there when you need us – ready to provide care in all ways. When faced with the decision to provide care, you need a trusted partner. One who has the knowledge gained from years of providing quality home care...
Making a Difference Home Care, LLC in Indianapolis, IN, is a home care provider that likely offers a range of services aimed at helping individuals maintain their independence and quality of life while receiving care in...
Our Mission At Divinity Home Care, we tailor our care services to cater to the specific needs of our clients. We value each client's uniqueness and strive to assist them with assistance in their daily living. Let us help...
At Prestige Loving Home Care, we are committed to delivering exceptional service to your loved ones. With a dedication to personalized care, we ensure every client experiences comfort and peace in their home and lives an...
When you have an aging family member in Greenwood, IN who may benefit from senior care, Senior Helpers Greenwood is here to help. At Senior Helpers of Greenwood, we offer comprehensive care, and can tailor a package that...
We’re intentionally different. We set the benchmark for excellent home care by balancing our friendly nature, person-centered approach, and discreet services with our love of helping you maintain your independence. It’s...
We’re here to help you continue living independently. If you or a loved one is having trouble with activities of daily living, home safety or personal care, we can provide a personalized care plan to make life easier and...
Arbor Village Services LLC is a dedicated home care agency specializing in providing high-quality, personalized care services to individuals in the comfort of their own homes.
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 C & C Probity Home Care Services LLC, our mission is to provide compassionate and personalized home care services to our clients. We strive to improve the quality of life for those we serve, while prioritizing their...
Dignity Home Care Services provides compassionate and professional in-home care solutions tailored to meet the individual needs of our clients. Our services are designed to support independence and enhance quality of life...
At Vesta Structured Family Care, we extend beyond traditional care services; our foundation is built on compassion and a personalized approach to support. We are passionately focused on serving seniors, driven by a...
Accucare Home Care LLC offers personalized, high-quality in-home care services for seniors and individuals with disabilities. Our experienced caregivers provide support with daily activities, medical needs, and...
TRUE2YOU HOME CARE LLC offers personalized, non-medical in-home care to enhance the quality of life for seniors and individuals with disabilities. Our services include personal care, companionship, light housekeeping, and...
Benevolent Hands, LLC is a dedicated home care service provider focused on delivering high-quality, compassionate care to seniors, individuals with disabilities, and those in need of assistance with daily living activities.
At Orange Home Care Services, our mission is to provide compassionate, personalized care that enhances the quality of life for our clients. We are dedicated to supporting individuals and their families by offering...
Elaine's True Companions provides compassionate in-home care tailored to the needs of seniors and individuals with disabilities. Our dedicated caregivers offer assistance with daily tasks, medical support, and heartfelt...
Luxury Care At Home LLC is a premium in-home care service provider specializing in offering personalized, high-quality care for seniors and individuals requiring assistance with daily living activities.
Nestled in the heart of Indiana, Supporting Angels Homecare proudly serves as a cornerstone of compassionate care and support for seniors and their families throughout the region. With a deep understanding of the unique...
MVP Care Services, based in Indiana, provides a range of in-home care solutions tailored to support individuals with diverse needs, including seniors and those with disabilities. Their services typically include personal...
Our talented staff is here to assist you and your loved ones. We have experienced nurses who have the ability to work with all patients no matter their expected needs. Based in Indianapolis, IN, we service 80% of the...
Shining Hearts Home Care LLC is a home care provider that services Indianapolis. Home care services allow seniors to remain safely in their own home while receiving assistance with personal care and other daily tasks.
Care Free Home Care, LLC is dedicated to providing high-quality in-home care services for individuals in need, including seniors and those with disabilities. The company focuses on enhancing the quality of life for its...
Absolute Caregiving LLC provides exceptional in-home care services tailored to the needs of seniors and individuals with disabilities. Our dedicated caregivers offer assistance with daily tasks, medical support, and...
Welcome to Reason To Love Home Care Agency LLC, your go-to home care services provider in Indianapolis who are looking for comfort and peace of mind. We provide a range of services tailored to meet the specific needs of...
Blossom Home Care Services, LLC is a home care provider that services in Indianapolis, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Care Providers, INC - Parent is a home care provider that services in Indianapolis, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A HOME CARE NEAR YOU INC is a home care provider that services in Indianapolis, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HEARTS LANDING HOMECARE LLC is a home care provider that services in Indianapolis, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Helpers Indianapolis helps families navigate the full continuum of senior care. Our in-home aides allow seniors to receive the day-to-day help with personal care they need and assistance with activities of daily...
CORNERSTONE CAREGIVING IN INDIANAPOLIS, INDIANA We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Indianapolis or in surrounding areas like...
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 are a home care agency with over 12 years of healthcare experience. Queen of Hearts Home Care is licensed, bonded, and insured. We complete an extensive background search on all employees, and equip them with the...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
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 Love and Grace our mission is to bring compassion back into home care. It is our goal to foster companships and meaningful caregiver relationships, improving overall health for individuals. Our caregivers provide...
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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.