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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:
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...
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If you are currently caring for a loved one that is having challenges living independently, we understand how difficult it can be. With the right kind of help, it’s possible to improve their quality of life so they can...
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At Emieric, we are proud to offer you and your loved ones the highest quality home care services. Our mission is to go beyond the industry standard by caring for you the way we would care for our own...
Assisting Hands is dedicated to providing reliable, compassionate home care that honors the dignity of each of our clients. Our team of highly trained professionals is committed to providing the same level of care we...
Homewatch CareGivers of Yorba Linda, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homecare Companions is a non-medical in-home care agency founded in 2022, dedicated to providing compassionate and personalized support for individuals who need assistance with daily living activities. The agency focuses...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
Exceptional Care for Your Loved Ones Our mission is to provide exceptional support to your loved ones in their golden years or those facing well-being challenges. Bella Vie Homecare LLC delivers premier care services...
Assistance In Home Care began with a vision by the owner, Ramona Streit. 17 years ago, her brother was suffering with cancer and he required in home care. Over time, the family realized the services that were received by...
Green Meadows In-Home Care is dedicated to providing compassionate, reliable, and personalized care for individuals who wish to remain in the comfort of their own homes. Our team focuses on promoting independence,...
Home Helpers Home Care of Orange Coast is more than an in-home health care agency – we’re your extended family when family can’t be there. We’re a locally owned, trusted provider of quality, compassionate in-home care in...
At Griswold Home Care for Laguna Hills, we offer compassionate in-home care for those who want support to live where they love. With over four decades of experience and a storied legacy of compassion and integrity, we...
Unlike in-home care franchises, Care for SoCal is owned and operated by two nurses-an RN and an LVN-with experience in multiple specialties of nursing and in-home care, for people of all ages and circumstances. Whether...
When you and a loved one in your life require care assistance, Executive Home Care is ready to lend a hand. Find out more about the expert and compassionate senior living care that is offered in the comfort of one’s own...
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'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 Serenity Home Care Group, we believe everyone deserves to age with dignity, comfort, and independence in the place they love most—home. Our compassionate caregivers are dedicated to providing personalized care that...
At Home Helpers® Home Care we offer personal care & companionship care. We assist with elderly care and the basic activities of daily living like hygiene, cooking, mobility, errands and light housekeeping to help your...
Being an essential service provider, Amada Senior Care is here for you 24/7 as we continue to operate through COVID-19. Count on Amada’s commitment to promoting your health and safety as a factor you can control during...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
At Caring Ember, we provide licensed and certified non‑medical home care throughout Orange County, Los Angeles, and surrounding areas. We take great care in in matching each client with trained, certified, and...
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
We know there’s no place like home. That’s why we bring the highest quality of care right to your front door. With a personalized care management approach and a dedicated team of compassionate caregivers, you can expect...
At Lynda's Home Healthcare, we began with a simple idea: to deliver reliable and compassionate in-home care services to those in need. Over the years, we have evolved into a trusted provider of quality personal care...
Oso Home Care, Inc is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OPTIMAL SENIOR CARE SOLUTIONS is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
We are here to support you with compassionate home care services. Our team offers a complimentary assessment to create a personalized care plan, helping you remain safely in the comfort of your home with the assistance of...
Acti-Kare of Irvine is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ativa Home Care - Newport Beach is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Absolute Health Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Green Tree Home Care - Orange County is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Operated by a married couple that holds a Bachelor of Science in Nursing degree. Having the passion to significantly improve the lives of the people by serving them in a S.M.A.R.T. way and consistently implementing the...
Home Care Placement is a local, privately owned in-home care, placement, and care management agency. Our mission is to provide a compassionate, world-class customer service experience to our patients and clients. Our...
365 Home Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
PURE HEART HOMECARE STAFFING AGENCY LLC is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Safe Guard Care Services, our mission is to provide compassionate, high-quality, and personalized care that enhances the well-being and dignity of every individual we serve. We are dedicated to fostering a safe,...
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...
When you or your loved one need help at home, turn to FirstLight Home Care of Irvine. We offer complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just...
As a family owned, not for profit organization, Canaan Home Care is at the forefront of the home care industry. Canaan has been a partner of the State of California for over 25 years, together, raising the home care...
Acti- Kare of Irvine provides senior care and home care services in the following locations including Irvine, Newport Beach, University Park, and Northwood in California.
At Golden Years Home Care Solutions Inc – San Diego, our mission is to provide compassionate, personalized, and dependable home care services that empower seniors and individuals with disabilities to live safely,...
With Koda Caregiver personal care services, we help your relative or loved one with intimate non-medical care needs. Our companion care services provide daily companionship and assistance with daily living activities (ADLs).
Acti-Kare of Irvine provides quality in home care services to families and seniors in Irvine, Foothill Ranch, Trabuco Canyon, Rancho Santa Margarita, Las Flores, Coto De Caza, Costa Mesa, Fountain Valley, Huntington...
At Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations as...
At Senior Helpers, we are here to help anyway we can -- no matter how big or how small the task. Our owners, Sandy and Hector Muñoz, know personally what it's like for the people in need of care and the toll it takes...
Golden Age Companions is dedicated to improving the lives of seniors and others who have reached the point in life where they need companion care. We’re dedicated to providing personable, hands-on, and integrated caring...
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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.