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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:
The entire professional care team at Amada Senior Care Philadelphia West Suburbs understands the importance of quality senior care that helps aging adults thrive and live safely and independently. Choosing the right home...
Formosity Support Services, LLC is a non-medical home health agency with over 10 years of experience providing compassionate and reliable care. They are dedicated to helping seniors and individuals with disabilities live...
Neighborly Home Care provides a comprehensive range of personal care services to assist seniors or anyone who needs help with activities of daily living, in their home or residence. We understand that maintaining your...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
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...
Golden Point Home Health Care Inc. is dedicated to providing high-quality, compassionate care that empowers individuals to live safely and comfortably in the place they call home. Our team of skilled professionals...
Together We Stand Home Care Services is a compassionate, client-centered home care agency dedicated to supporting individuals and families with dignity, respect, and reliability.
At Take My Hands LLC, our mission is simple: take our hands and we will make a difference in your day. We provide personalized, non-medical home care services designed to support independence, dignity, and overall...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
L&R Home Care Agency, LLC is a trusted provider of personalized in-home care services dedicated to helping individuals remain safe, comfortable, and independent in the place they call home. We offer a compassionate range...
Our in-home care services brighten the lives of seniors, who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier through compassionate support,...
Neighborly Home Care - Ardmore is a home care provider that services in Clifton Heights, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comprehensive Home Assistance Whether you are struggling with loss of mobility, disability, or illness, we are here to give you the helping hand you need. Our home assistance services cover everything from light...
MMKOL Community Health Services is dedicated to delivering compassionate, non-medical home care that supports independence, safety, and quality of life.
MRC Hospitality Group LLC is a home care provider that services in Clifton Heights, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SOOTHING CARE HOME CARE LLC is a home care provider that services in Clifton Heights, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our caregivers and aides provide help with activities, light housekeeping, medication reminders, and companionship to help seniors, elderly, or physically challenged adults function independently in their own homes . Our...
Delaware Valley Quality Care is a state provider of home care and staffing services with experience and dedication to enhancing the quality of life for others. We are proud of our compassionate home care program designed...
The Agency That Cares. Gentle Hearts Home Care Agency, LLC is the premier non-medical home care agency in Delaware County, PA. Serving seniors and those in need throughout the Delaware, Montgomery and Philadelphia...
We strive to be a leading provider of home and community-based services, recognized for delivering compassionate, respectful, and individualized care that empowers every person to live a fulfilling and independent life.
OTITI CARE LLC is a home care provider that services in Clifton Heights, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Based in Philadelphia, Pennsylvania, the agency focuses on helping clients maintain independence and dignity in the comfort of their own homes. Their offerings include assistance with daily living activities,...
Engage As You Age Home Care LLC provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, companionship, and...
CORE CARE HOMECARE is a home care provider that services in Clifton Heights, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ariel Home Care, LLC is committed to providing compassionate and reliable in-home care services that support independence, dignity, and peace of mind. Our dedicated caregivers assist with daily living activities,...
Welcome To Gina's. HomeCare Services At Gina's HomeCare, we believe in supporting independence, promoting well-being, and helping each client live life to the fullest. Where compassionate care and quality homecare...
Heroic Home Care LLC is a home care provider that services in Clifton Heights, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Care Services LLC is a home care provider that services in Clifton Heights, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BGM GOUSSE FAMILY CARE AGENCY, LLC. is a home care provider that services in Clifton Heights, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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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.