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:
Always Best Care combines national strength and standards with local accessibility and personal service. Your local Always Best Care team will be helping families throughout Roswell and Surrounding areas to provide...
Better with Betty Homecare was founded by Shantay Betty-Denton, a special education teacher with over 25 years of experience. Inspired by her personal journey and dedication to serving others, Shantay created Better with...
We understand that receiving care at home is a personal decision. At Harmony Angels, we’re dedicated to providing compassionate and high-quality care that allows you or your loved one to live life to the fullest, in the...
Home Instead Kennesaw has been providing extensive in-home care services in the Atlanta area for over 15 years. Home Instead can tailor a home care arrangement to fit both your family's lifestyle and budget.
Senior Helpers - North Metro Atlanta is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Priority Home Care, we understand that each individual has unique needs and preferences. That’s why we’re committed to providing personalized solutions tailored to you or your loved one. Our dedicated team of...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
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...
Charlotte Web Private Home Care, LLC is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Loyal Care is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Honeybee Homecare is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angels On Wheels HomeCare is dedicated to providing you with quality care from our professional, compassionate caregivers. We strive to be the best at HomeCare Assistance to give you a peace of mind while caring for you...
At Roswell Home Care, our goal is to keep you or your loved one safe in the comfort of their home, enhancing quality of life and preserving independence. We commit to providing exceptional health care services in a...
Accent Care is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Golden Home Services is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Since 1975, Bayada Nurses has helped people have a safe home life with comfort, independence, and dignity. Bayada Nurses provides skilled, rehabilitative, therapeutic, and personal home health care services to children,...
INTERMED HOME CARE INCORPORATED is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homekeepers Healthcare is a licensed Companion Care registry that offers you choices......and a better way! We specialize in live-in home care that enables your loved ones to maintain their freedom, and a well...
Loving Comfort Home Care LLC, GA is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Safeway Healthcare, Inc is insured and licensed in the state of Georgia to provide Personal Home Care services in the following counties:- Cobb, Dekalb, Fulton, Clayton, Gwinnett, Forsyth, Rockdale, Coweta, Feyett and...
FAMILY PRIVATE CARE offers premier caregiver referrals to seniors in the comfort of their residence. All caregivers are thoroughly screened using the strictest screening criteria possible. This assures seniors and their...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
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,...
FAMILY PRIVATE CARE, LLC is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Every Alpharetta family faces the challenges of caring for a senior family member differently. No matter the circumstance, the right caregiver can give you and your family respite while helping your loved one enjoy daily...
BROOKDALE AT HOME ROSWELL is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Abundant Life Assisted Services is an in-home care service provider designed to deal specifically with the needs of the elderly, disabled, and chronically ill individuals in the area who wish to remain in their homes. Our...
Lotus Family Care LLC is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARAVITA HOME CARE is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Rasmussen Home Care and our experienced caregivers have served seniors and their families with exceptional home care. We provide older adults in Atlanta Georgia and the broader community with one-on-one support that...
A L Gordon Care Group Inc is a home care provider located in Roswell, GA 30076, offering services designed to help seniors remain safely in their own homes while receiving necessary medical or personal care.
ABUNDANT LIFE ASSISTED SERVICES, INC is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our personal caregivers offer assistance with activities such as: - Personal grooming, bathing, toileting, and hygiene tasks - Mobility and transfers - Medication reminders and monitoring - Companionship - Light...
Alliant Home Care, LLC is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
MY PARENTS KEEPER INC is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Guardian Home Care, LLC is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ASR HOME CARE, LLC is a home care provider that services in Roswell, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When retirees across Greater Atlanta could use help living independently at home, remember A1 Active Care. Put more than 30 years of nursing healthcare experience to work for your family. We send skilled nurses,...
Experienced owner with demonstrated history of working in the hospital & healthcare industry. We provide care from few hours a week to 24 hours a day, 7 days a week, including overnight services and or live-in services....
At Home Matters Caregiving of North Atlanta, we provide homecare that strives to keep our clients as independent as possible; improving quality of life, longevity and provide peace of mind.
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.