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.*
✔
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:
Home—there’s no place like it. It’s where your memories are. Where you raised your family and where friends have gathered for life’s celebrations. It’s been your basecamp through good times and bad. And it’s where you...
At Visiting Angels Arizona, we know that care is most effective when it’s built to fit your life. That’s why our in-home care services are carefully tailored to every client’s schedule and lifestyle. When you choose...
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Senior Helpers of Scottsdale was proud to join the exceptional team of over 300 other Senior Helpers owners in 2007. Shaun Phelan was inspired to start providing quality care to the senior population after he witnessed...
Gold Star Home Care LLC is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Winner of the Best of the Valley 2023 & 2024 & 2025 Being recognized & voted by our clients as Best of the Valley in Home Health Care for consecutive years is a direct reflection of the seniors and families who have...
Welcome to SYNERGY HomeCare of the West Valley Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that...
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...
To empower our clients to maintain their independence, dignity, and quality of life, by providing exceptional in-home care services tailored to their unique needs, and building trusted relationships with them and their...
Welcome to Visiting Angels of South Phoenix! We proudly serve the communities of South Phoenix and surrounding areas, including Ahwatukee Foothills, Maricopa, Buckeye, Laveen, Surprise, and Waddell. Our non-medical home...
HomeWell Care Services of Glendale, AZ is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Griswold is an award-winning pioneer in the home care industry, with over four decades of experience and a storied legacy of compassion and integrity. We believe Care Professionals are the foundation of our success, and...
Steady Homecare is a trusted provider of compassionate, in-home support for seniors and adults who wish to maintain independence in the comfort of their own homes. Our dedicated caregivers assist with everyday tasks,...
Brightwood Health is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Whether it’s helping with chores, providing medication reminders, or meal assistance, ComForCare gives you the freedom to focus on spending quality time with your family members and loved ones.
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...
Cornerstone Caregiving specializes in providing comprehensive healthcare solutions tailored to meet the diverse needs of our clients. With a commitment to excellence and a focus on patient-centered care, we deliver...
Our team has a deep understanding that home is not only a place to live but also, at times, a clinical setting where professional support matters most. Families do not reach out because everything is fine. They reach out...
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...
Griswold is an award-winning pioneer in the home care industry, with over four decades of experience and a storied legacy of compassion and integrity. We believe Care Professionals are the foundation of our success, and...
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...
Addus Home Care is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amazing L&i Home Care Services LLC is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All N One is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angies Angels Home Health Care is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We do CARE a little differently We’re a family-owned franchise located in the heart of the Paradise Valley Area. We believe it’s time the in-home care experience became more personalized, positive, and powerful....
Anchors Homecare LLC, Compassionate In-Home Care Services At Anchors Homecare LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence. Our...
A-Z Home Care Options, a division of Reliable Staffing Solutions, is a comprehensive service company owned and operated by individuals who have been in the medical industry for a combined total of 30 years. With over 20...
A Better Living Health Care is a non-medical home care agency located in Phoenix, AZ, dedicated to providing compassionate and personalized care for seniors and individuals with disabilities. The agency offers a wide...
Absolute Home Care, LLC is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alpha Healthcare, Llc is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AlwaysOn Home Care: We understand that choosing a caregiver for your loved one can be a decision laden with worry and anxiety. You may ask yourself many questions such as, “Will the caregiver be sensitive to the needs of...
Touching Hearts at Home of AZ is a home care provider that services the West Valley. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
Home Matters Caregiving is compassionate care you can depend on. Discover the benefits of professional caregiving in the comfort of your home. Learn how a Professional Caregiver can help create great days for your...
Seniors Helping Seniors® Scottsdale's 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 by providing...
HomeWell Care Services of Scottsdale, AZ is a home care provider that services in Phoenix, AZ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Phoenix or in surrounding areas like Downtown, Midtown, or Tempe.
Home With Help is a trusted provider of comprehensive non-medical companionship / home-making and Personal Care Services in the Greater Scottsdale, Phoenix Arizona. We are committed to providing the most compassionate,...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Northwest Phoenix or in surrounding areas like Glendale, Peoria, or Surprise
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 Tempe and surrounding communities providing...
Griswold Home Care is available to assist you and your family with your home care needs. We specialize in providing quality home care with consistent, experienced caregivers, including live-in home care.
Senior Helpers of Tempe was opened by owner John Skelton in 2020 as a mission-driven business for the greater good. John and his dedicated team recognize the growing need for in-home care services and are committed to...
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 Heart Senior Care offers the highest quality companion care, home care services and personal care services so our clients can live a full and independent life in the comfort of their home. Golden Heart Senior...
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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.