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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.
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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:
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead Senior Care® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance...
Barry and Amy Petersen-Smith and their team of well-trained professional caregivers have been providing exceptional in-home care to seniors throughout Charleston, Dorchester, and Berkeley Counties. Whether you need...
BAYADA Home Health Care in Charleston, SC provides personal care services and non-medical assistance with activities of daily living (ADLs) for adults and seniors when a health issue has made it difficult to manage...
Always Best Care of Charleston is a preferred senior care organization that is recognized for providing top-notch in-home care, personal assistance, and assisted living services. Partners in business and in life, Rick and...
Our Home Care Services The realization that Mom or Dad isn’t an all-knowing superhero is one everyone discovers as they age out of childhood. That doesn’t make it any easier when the tables turn and the ones who cared...
Your loved ones have invested their entire lives taking care of you and being there when you needed them. Now that they have reached retirement age, it's your turn to be there when they need you the most. However, if you...
Our in-home senior care starts with a clear understanding of who you are and what we can do to make your life a little easier and a little brighter. Whatever services you need and whenever you need them – for yourself or...
Visiting Angels Charleston offers premier Senior Home Care Services to Charleston, S Berkeley, and SE Dorchester County residents in South Carolina. Our in home care services give seniors the opportunity to overcome the...
There's no place like home, especially when you're not feeling well. Our homecare staff will help you live safely at home with expert and responsive care. Senior Care Services philosophy is "Partnering with Seniors and...
We are a non-medical, in-home care provider who offers resources and solutions to guide and support families every step of the way. With today’s technology and advancements in health care, people are living considerably...
Brightstar Care - Mt Pleasant, SC is a home care provider that services in Mount Pleasant, SC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome! When seniors or others need long or short-term assistance with their daily living needs, home is the most comfortable and convenient place to receive care. Companion Care USA provides non-medical companion/...
Home Helpers Home Care of Goose Creek, SC is your trusted partner for comprehensive in-home care services. We are committed to providing exceptional care to older people and the differently-abled, promoting independence,...
Whether you have an aging loved one, someone recovering from a fall, a family member with special needs, or anyone with in-home care requirements, Lucky Dove Home Care has you covered. We are dedicated to providing only...
Low Country Be Well Home Services is a home care provider that services in Mount Pleasant, SC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
FirstLight Home Care of Charleston, SC is a home care provider that services in Mount Pleasant, SC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
People want to live their lives where they feel most comfortable – in their own home. We offer a range of services, from basic companionship to round-the-clock care, that allows seniors and other individuals to remain in...
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...
A BETTER CHOICE HOME CARE is a home care provider that services in Mount Pleasant, SC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Care Plus is an in home elder care and support service located in Mt. Pleasant South Carolina whose goal is to help elderly clients live life as fully and safely as possible in the comfort of their own homes. We...
For nearly 20 years, TheKey (formerly Home Care Assistance) has helped clients achieve successful long-term aging at home with comprehensive, concierge-based care. Ensuring the dignity, safety, and independence of its...
At Lucky Dove Home Care, we pride ourselves on providing highly qualified & reliable in-home care services to support the needs of you and your loved ones.
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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.