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:
Right at Home Birmingham offers special education and training for our staff regarding Stroke recovery, Hospice care, Cancer care and many more special circumstances. Right at Home Birmingham offers free in-home...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
SYNERGY HomeCare of Birmingham provides personalized in home care that helps individuals stay safe comfortable and independent at home. Services include companionship personal care memory support recovery assistance and...
At SLS Caregivers our commitment is to transform the way in-home care is experienced by blending compassion, excellence, and truly personalized support. Our mission is to help individuals live safely and comfortably in...
At Homewatch CareGivers of Birmingham-Hoover, we believe everyone deserves compassionate, personalized care that honors their dignity and independence. As a locally owned franchise backed by a brand with over 30 years of...
JUNUH IN HOME AND HEALTHCARE LLC is owned and operated by nurses and healthcare professionals with more than 30 years of experience in the healthcare industry. Our caregivers are COVID-19 tested, background checked, drug...
All About Care LLC in Alabama is dedicated to providing compassionate, dependable, and personalized home care services that enhance comfort, dignity, and independence. Our trusted caregivers assist with daily living,...
With Quality 1 Home Care, not only are you receiving one-on-one in-home care and support as often as you need, but you're also working directly with a medical professional who has the expertise to give you peace of mind....
Right at Home Birmingham East provides a range of in-home care options for seniors and adults with disabilities. Don’t think of our services as one-size-fits all. We know everyone’s needs are different, so our care plans...
One2Care Elderly Services provides compassionate, personalized in-home care with over 25 years of experience. From a few hours to 24-hour support, our trusted caregivers assist with hygiene, daily tasks, medication...
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,...
Riverdale Health Group LLC. is committed to giving you the best care for your loved ones. We take pride in our supportive service care experience with our client. The first step to meeting our clients needs starts with...
At Cornerstone Caregiving, we are proud to serve Birmingham, AL and its surrounding areas, offering compassionate in-home care for your loved ones. We take the time to get to know each client individually, ensuring their...
At Care First Home Care, we believe in providing compassionate, quality in-home care to you and your loved ones. We understand that your family member’s health and safety is a top priority, We strive to promote the health...
Meridacare is a home health and community-based service agency based in Alabama We believe in absolute client satisfaction. It is our conviction that Total Quality Care will be the guiding principle and cornerstone of...
Positioned By Grace LLC is a compassionate home care agency proudly serving individuals and families across Alabama. We are dedicated to providing reliable, high-quality non-medical care that supports independence,...
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...
Right at Home Gardendale provides a range of in-home care options for seniors and adults with disabilities. Don’t think of our services as one-size-fits all. We know everyone’s needs are different, so our care plans are...
Comfort Keepers of Birmingham, AL, offers a variety of services tailored to meet the individual needs of each senior in our care. Our caregivers work diligently to enhance the well-being of seniors and support their...
Gentle Touch Home Care is a compassionate and reliable home care provider dedicated to supporting seniors and individuals with disabilities in the comfort of their own homes. Our trained caregivers deliver personalized,...
Gentiva Health Services is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Over the years, Dailyn Caregivers have remained the most preferred non-medical caregiver of choice for families. Our skills and ability to offer comprehensive and practical solutions for day-to-day challenges has...
ATC Healthcare Services, LLC is the leading staffing provider of readily available nurses (LPN and RN) for the north and central regions of Alabama. We are responsive and have the largest free standing pool of reliable...
A leading in-home senior care company that has been trusted for over a decade, Acti-Kare, provides in-home elderly care to thousands of individuals every year and has constantly been ranked a leading senior and elderly...
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...
Comforting Hearts Personal Care - Birmingham, AL is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
B&C Loving Caregivers is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alacare Home Health & Hospice is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Able Homecare of Birmingham is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Birmingham, AL is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission at Covenant Home Care, LLC is to provide compassionate and reliable in-home care services to those in need, allowing individuals the opportunity to stay in the comfort of their own homes while receiving...
Ariel's Helping Hands LLC, Compassionate In-Home Care Services At Ariel's Helping Hands LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
Lipford Home Care is a home care provider that services in Birmingham, AL. 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...
Here at All Saints Home Health Care, we pride ourselves on coming up with innovative ideas that let us better serve our clients. We’re problem-solvers, innovators, and offer a complete range of services designed to meet...
Always There In-Home Care, Inc. is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ameriCARE Birmingham believes it’s time the in-home care experience became more personalized, positive, and powerful. We bring our own experience, compassionate caregivers, and the industry’s best communication tools to...
The vast majority of today’s healthcare consumers and especially seniors want to stay in their home as they age, but sometimes independence needs a helping hand. That’s where in-home personal care and support services...
Our Purpose: At Hallmark Homecare of Southeast and Northeast Birmingham, we prioritize quality care by placing experienced caregivers in your home, while respecting the dignity and independence of the aging adults we...
Angel of Mercy ElderCare, LLC is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Since 2000, we have served Jefferson County and the greater Birmingham area with excellence in home care. We are a locally owned company dedicated to improving the lives of our clients with quality in-home care. Choice...
Heart to Home has a small group of reliable, experienced CNAs, who are also dementia specialists (if that is helpful), CPR certified, vaccinated caregivers to provide individuals with companionship (engagement activities...
Home Helpers In-Home Care Services is more than an in-home health care agency: we are your extended family when family cannot be there. We are locally owned and a trusted provider of quality, compassionate in-home care....
ComForCare Home Care is a premiere home care provider specializing in dementia care and chronic conditions serving Birmingham and surrounding areas. We have a personalized approach to home care. We understand that...
Amada Senior Care is Birmingham’s premier home care agency where reliable caregivers anticipate your care needs, and we customize your experience with our unique senior home care plans. As Long-Term Care Insurance...
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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.