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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:
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
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 moves people, and their loved ones, emotionally and...
Our mission is to deliver client-centered, wrap-around health management that guides individuals and families. Our vision is to be the bridge that closes gaps across the healthcare continuum.
It doesn’t matter if you’re here because you’re looking for help living independently, or if you want to make sure someone you love has the support they need to stay in their home. We believe there’s more to caring for...
Achieving Friends Home Healthcare Inc. is a compassionate home care provider serving communities across North Carolina. Dedicated to enhancing quality of life, they offer personalized support including personal care,...
You’ve probably seen it with loved ones. An elderly person checks out of a hospital or nursing home only to be readmitted within a few months. During the transition, medications weren’t taken, doctor appointments...
At Senior Helpers of Holly Springs, we specialize in providing personalized, non-medical care tailored towards meeting the unique needs of each individual client. Our mission is to foster independence while ensuring...
At Amada of Raleigh and Eastern North Carolina, we provide non-medical in-home care for seniors. We know how important it is for our clients to continue to do the things they love at home, so we help make life easier and...
At Friendly Forever Homecare, we are deeply committed to redefining the standards of care for our clients. Our services cater to individuals’ diverse needs, ensuring that they receive the utmost care, support, and...
A1-Omega Health Services is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Licensed for Hands on Care and Companion Services Fully Insured Licensed by the Department of Health and Human Services Division of Health Services Regulation Covering 14 counties out the Raleigh office: Wake, Alamance,...
We know there’s no place like home. That’s why HomeWell brings you the highest quality of care so you can maintain your independence and experience life to the fullest.
Let us help you understand your home care options, including a full range of integrated care that meets the highest quality standards for compassion and reliability.
Allcare Home Health Agency, was established because of our passion for taking care of seniors, disabled and special need adults. Our agency is composed of a multi-disciplinary team of nurses, home health aides, care...
Ally Health Services, LLC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aspire HomeHealth Services,LLC We're committed to providing compassionate care and support to individuals and families in our community. We understand that navigating the complexities of healthcare can be overwhelming,...
Atlantic provides a wide range of homecare services including non-medical companion and personal care, as well as, both pediatric and adult private duty nursing. Our professionals partner with our clients and their...
At Home Eldercare is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Absolute Care Staffing Health Agency, Inc. is independently owned and operated. It was founded because we saw the need to provide compassionate and caring professionals to treat home care clients with the care, the...
QUALITY SENIOR CARE AT HOME The Senior Care market is a rapidly expanding industry that continues to be competitive. We differentiate ourselves every day with the quality of our senior care services, how we speak and how...
Offering a wide range of services that are delivered by highly skilled professionals who are committed to meeting the emotional and physical requirements of clients and their families.
Accessible Home Health Care of Mid Carolina creates a high-quality, safe environment for your loved ones, allowing them to stay in their own home and receive the care they need. Accessible Home Health Care is the...
Bright Home Care Services, LLC is a home care provider that services Raleigh, NC 27610. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
American Medical Equipment & Supplies, Inc. is a home care provider that services in Raleigh, NC. 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,...
Our In Home Personal Care Services include, but are not limited to Bathing Dressing Toileting Life enhancing activities Alzheimer’s / dementia care Incontinence care Meal preparation Feeding assistance Medication...
All Life Home Care's goal is to provide professional, compassionate care to individuals. While Maintining their independence and quality of life in their home or community.
Allied Home Health Care Services, Inc. is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All Time Health Care Inc. is a licensed home care agency based in Raleigh, North Carolina, providing in-home care services to individuals with functional, physical, or mental impairments.
A and M Home Care is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amen Home Care Agency, LLC is a reputable, Raleigh-based nursing care agency providing in-home skilled nursing services—staffed by RNs and LPNs—for private-paying clients. It’s a licensed, locally operated business ideal...
Our vision is to be the most trusted home care provider in our community, known for delivering compassionate care, improving quality of life, and helping individuals live independently in the comfort of their own homes.
Best Home Healthcare Agency, LLC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OG Healthcare provides non-medical in-home care with years of experience, helping seniors and individuals with disabilities maintain independence. Our compassionate caregivers assist with daily tasks, ensuring safety,...
Bluecross Home Care and Health Services Inc. is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AlbertaCare LLC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Raleigh, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care offers a wide variety of high-quality services—from in-home care to medical staffing. If you are looking for a trustworthy care provider or staffing partner in the Midtown Raleigh / Durham, NC area, please...
At Home Quality Care Inc is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aipeck Health Group, Inc. is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angels that care and where love and healing is brought to your home. As dedicated care professionals we restore balance, order, and peace to your lives, by helping your love ones remain safe at home. We've been...
Our Story 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...
Options Home Care of Cary, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
One You Love Homecare Chapel Hill and Raleigh, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Services -Companion Care For our basic level of care, caregivers provide services such as companionship, meal planning and preparation, light housekeeping, laundry, medication reminders, and other general assistance....
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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.