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:
We at FirstLight Home Care exist to help people have their best day, every day. Our mission is to provide compassionate home care so that the families we serve have peace of mind knowing their loved ones are receiving the...
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...
Integrity Home Care Agency LLC is a compassionate, client-focused home care provider dedicated to helping seniors and individuals maintain independence, dignity, and quality of life in the comfort of their own homes. We...
At Vision Home Agency, we are dedicated to all of our clients. We offer 24-hour and live-in-home healthcare services to clients in King County, Pierce County and Snohomish County. Whether you need shorter, hourly...
At Classique Homecare and Staffing Solutions LLC, we believe that everyone deserves to feel safe, supported, and truly cared for — right in the comfort of their own home.
Elite Care Northwest is a physician-owned and managed home health agency based in Seattle, Washington. Founded and led by Dr. Paradis Reed, who has over 15 years of experience in Emergency Medicine, the agency offers a...
Homewatch CareGivers of Mountlake, WA is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are dedicated to providing excellent, extensive, humane and respectful home care services to the communities we serve, while providing comfort in their own homes or other areas of their choice. At Handy Care, clients...
For 24 years, TheKey has earned the trust of more than 120,000 clients by delivering 12 million hours of personalized home care each year using our science-backed Balanced Care Method® that actively supports well-being....
Senior Helpers is the premier provider of senior care, wherever your senior resides. We provide in-home care and personalized care in the comfort of your own home and at other residential locations including assisted...
Essential Home Care NW is a compassionate non-medical in-home care provider serving seniors and adults in the Puget Sound region from its base in Bothell, WA. The agency specializes in helping clients live safely,...
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...
At HomeWell Care Services, we provide live-in and hourly at-home care for seniors and others who are struggling to manage day-to-day activities like grooming, bathing, cooking or even running errands. Our knowledgeable...
At Adella Eldercare, we are dedicated to providing comprehensive in-home care services for seniors and staffing CNAs to Assisted living facilities, rehabilitation facilities and Hospitals. We understand the importance of...
Cornerstone Caregiving is proud to serve Central Seattle and its surrounding areas, offering exceptional in-home care services. Our caregivers take the time to get to know each client individually, providing personalized...
Agilosi Home Care Services, LLC is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aide Home Care is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Holistic Healthcare LLC, WA is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kline Galland Benaroya Community Services is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We deliver compassionate home health care and skilled nursing services to seniors in every home within the communities we serve, elevating their journey through exceptional support, peace of mind, and confidence.
Amicable Healthcare, Inc. is a health care agency licensed by the Washington State Department of Health to provide home care and Home Health services for elders and disabled people who are unable to carry out certain...
Goldencare Homecare LLC is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A CARE MANAGER ASSISTS YOU If you are like most people, you have never had to deal with matters related to care giving, so you probably have lots of questions. And, if you do have experience caring for others needing...
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...
Chesterfield Health Services is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Help Unlimited Homecare is not a franchise. We have been in business since 1975 and remain to this day family owned and operated. A high percentage of our caregivers have been with us for years. Our caregivers are...
DUPLICATE - Hubaal Homecare Agency is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
iding Quality Senior Care Wherever You Call Home in Tukwila, WA and the Surrounding Area We provide care in the home, wherever that may be. Whether you and your family need a short term companionship option or more in...
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...
Whether providing short-term assistance or long-term support, our team is committed to enhancing well-being and fostering peace of mind for both clients and their families.
Premier Home Care, one-on-one Assistance for the Elderly and Disabled in your own home. The quality of our services is a reflection of our CAREgivers. They are highly qualified and carefully selected individuals. Each...
In Your Home or Ours is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In-Home Reminiscent Care Our care-givers are trained to work with the clients on creative projects, having fun building new skills and new experiences that enhance their lives while remaining in their homes....
Comforcare Home Care of Seattle, WA is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heartland Home Health Care is a home care provider that services in Seattle, WA. 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...
Right at Home of Seattle, WA is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Home Health Care LLC is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
You have a choice to pick the best homecare agency in Washington. Here at American Healthcare Services, Inc., we help you live your life to the fullest through our advanced home healthcare services. There is a growing...
B’Zoe Home Caregiving Services was founded by Prossie Lockett, who immigrated to the United States from Uganda. Although she worked in the embassy, she opted to leave her home due to many reasons, including genocide, in a...
Guest Home Care provides reliable, compassionate in-home support for seniors and adults who need assistance while maintaining independence at home. Our caregivers help with personal care, companionship, meal preparation,...
Seniors Helping Seniors® is committed to providing seniors in our community with the ability to choose an independent lifestyle and remain in their homes for as long as possible with the dignity and respect they deserve....
Sometimes the best move is to stay right where you are – at home. Given a choice, most of us would age in our own homes. Yet too often people go through the challenges of moving when they could get the care they need...
Integrity Care and Staffing is a home care provider that services in Seattle, WA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SeaCare In-Home Care Services SeaCare was born out of the need to do better for our loved ones and our community. The founder of SeaCare witnessed her grandmother receiving subpar care, and she knew the only way to make...
Griswold Home Care is a non-medical home care company. We refer Caregivers who provide in-home care services including personal care, homemaking, companionship, and other home care services. Griswold Home Care was...
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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.