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:
Miz..I don't like people who drive loaded to the point they can't drive and will cause an accident and horrible consequences. I say drink eat and be merry just sleep it off or a drink a gallon of Starbucks before you go out on the road. Best is to party at home with friends and a sleeping bag if you must sleep it off..lol! Last week I don't know if you read my post but the girl next to me in a left turn lane got wacked by someone running the red light...good thing it was only her bumper that was ripped off and she was okay.....could have been me...and I am such a rebel I don't wear seatbelt all the time....yikes!
And Pirate, I still may take up drinking again when all is said and done. A margarita on the rocks with salt sounds sooooooooo yummy on the boat. I can just picture it now. What fun that would be.
Well, the men were very kind actually. It's not pleasant to lift a car at 1.00 p.m. under the summer's sun! I forgot to say Happy Birthday to Rip's dad (I'll write you in 5 minutes). I don't like Lambrusco, it's too strong and heavy. But wine and grass can help you sometimes! Tonight, I would like to take advantage of a bottle I have in the fridge, but I have to work! So, wine is for tomorrow!
deef...then def check out Chowder - total stress relief for me cause it is SOOOOOOOO zany!
miz.....sometimes we make some margarittas from scratch at home with Sauza Hornitos - agave. Yum...last year at the county fair they had a booth, and when you buy the 14.00 drink it came with the shaker (plastic but cute). We then mimicked this same cocktail all year. It was at the Sauza booth. County Fair is coming up...and boy oh boy cannot wait.....gonna get that 1 FOOT LONG CORNDOG...been waiting an entire year. Last year I did not get it.
Rossella you think Lambrusco is heavy...man I drink that stuff like Kool-Aid.
Okay Rossella try Stella Rossa...that's another Italian wine we had recently found and oh my god drinking that is like drinking sunshine...with it's slight efferesence...so yummy.
miz - have you seen the colored sugars and salts for around rims of glasses? I bought some red sugar at a Halloween clearance at Michaels and was putting it on the rim of our margaritta's at a Halloween party we went to last year...we were Vampires.
I prefer white wine in general. The only red wine I really like is "Corvo di Salaparuta" which comes from Sicily. And I like dry wine! The wine I have in the fridge is a present of a local producer and it's not the best thing I have tasted in my iife, but you never refuse a present!
Ok now you're talking. I like wine and Margaritas!
Rossella, I think we have to keep you of the bridge of the boat :)) We will let Bobbie do the navigating! Glad to know you and mom are safe.
Pirate - WEAR A SEATBELT. I losted a dear friend because she did not wear a seatbelt.
Jsomebody - We can all be annoying
Rip - Happy Birthday to Dad. When is or was your birthday.
Deefer - Everytime I went to post something I forgot to wish you a happy birthday. Happy Belated Birthday!
Bobbie - I love the ocean. I come from a seafaring family. And i cuss like a sailor!
Mom has been having a rough few days and sure enough it turns out to be a UTI. She new she wasn't feeling well, but got scared and swore it was something worse.
I have to run to the grocery and send money to a friend in need.
Whao glad to see Rossella is ok and the car thing is unreal I can see it. Saw a clip on line stretch stretch limo in San Francisco...you CAN'T do that, back end one place on top of hill front end hovering in space...Bet they charge extra for that...
Diane, I feel you do not trust me anymore as a driver! Well, Okay, I will not drive the boat. Jen, If I wanted to climb the sidewalk on purpose I would never have managed to do it. Im glad my car is little, it it were a Limo I would be still there. Otherwise, that gentleman should have called all the men of the village to free my car. My desk is full-full of little insect-sinners corpses. I shall have to remove tons of dead biomass in the next days! BTW cuss means "to smoke cannabis"? I'm not sure
Fornicating bugs-thats too funny- I asked my neighbor how to make moonshine-he knows how to drink it, but not how to make it.My daughter likes the cartoon CHOWDER also. We have a new sheriff,rumour has it he's going to be picking on some folks thats how they get their money,by taking peoples cars and houses,don't think they want it taxed down here,rather have someones property. Going on a school field trip tomorrow,a good many of the mothers are doctors or doctors wives or lawyers wives,talking about being the odd ball. I just tell myself I will not embarass my daughter,so I will keep quite and smile alot. Did ya'll read Ed's response about weedeatting a few weeks ago,it made me laugh my behind off.I'm still having fun with it.
"Cussing" here is using bad language in mixed company ie "they was cussin like a sailor..." Though it only applies when one is not in a group of people made up of... well... only sailors.
I think 'cussing' for smoking pot is hilarious Rossella!
"Where's (insert name of pothead)?" "Out back cussing up a storm. Yesterday was Sunday and he cussed all day. Woke up cussing. He didn't cuss this morning, and went to work but as soon as he got home out came the cussing. He'll probably cuss all night and pass out after eating everything in the house." "Sounds like cussing can be expensive!" "You said it! When we got married I didn't know he cussed like this! What with the cussing and the extra food I had to get another job!"
Yes, but you can use voodoo dolls for a lawyer they come with little suits and brief cases. I wanted to be a lawyer at one time it is a necessary evil in this world but I think it gets out of hand at times..There by one has recourse..The Bar, suing the lawyer..and the a fore mentioned voo doo doll comes in male and female, all races with horns or with out horns. $14.95 plus shipping and if any one can make one I will take one...
AND whilst one can cuss a lawyer one must NEVER cuss a judge..they have little ordinary people voo doo dolls and can unleash on you some serious type whoop ass(this is cussing).
Ah, Okay. I am specialized in cussing. While I smoke pot very rarely, just when I am in good company, when I do not have to drive! But I like it. I like both. Cussing and smoking pot. And drinking. Hope to cuss, smoke pot and drink all together very soon!
Lawyer voodoo dolls-I like that idea-that could relieve some stress. I onced told a judge I reported him to the FBI, that might be worse than cussing.I thought about moving after that-He was a ole drunken judge-I use to think you had to be a drunk to be a judge. The people that are hired to be the authority can be confusing.
Before hubby and I got married, the pastor asked both of us what we would like to change about the other person. I said that hubby cusses too much. Hubby said to the pastor, "I think I cuss the right amount." or something like that. :)
Rossella, I like white wine too. Dry white wine. I found a brand called Fre and it's wine with the alcohol removed. I can slam a bottle of that in one night, no problem. Love using wine glasses too. Feels so special occassionish.
The judge was indisbelief and then I got harassed by the cops everytime I turned around.A bigshot lawyer that wasn't afraid of other lawyers or judges called me up telling me he heard what I had done and told me that I needed help and he helped me,so I have had one positive experience with a lawyer. He is in his 80's now and very forgettful.He was very important and respected,so just knowing him was enough.I guess I expect other lawyers to live up to his standards,but he was a human first-lawyer second.My dad made me believe I was important-titles mean nothing to me-a jobs a job.A judge is paid by our taxes-he works for us,they forget that.When I reported him,they knew exactly what county I was in and who he was.Some people thought I was fearless,some thought crazy.Other people hated him too,I'm just vocal.I guess I try to be like my dad but it seemed to work better for him. You would be in court for something and he would stare at your breasts,if he was half drunk he would be in good mood if he was hung over he would be a jerk,nothing ever came of it. He got promoted and went into politics in Nashville---how encouraging.
You know I think that actually is listed as necessary requirement for entering politics. You are like an ombudsman or something, some one who stands up and says this is bull shit! And finally something gets done about it!
And you are right we vote for them we pay em they can answer to us!
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 forgot to say Happy Birthday to Rip's dad (I'll write you in 5 minutes). I don't like Lambrusco, it's too strong and heavy. But wine and grass can help you sometimes! Tonight, I would like to take advantage of a bottle I have in the fridge, but I have to work! So, wine is for tomorrow!
miz.....sometimes we make some margarittas from scratch at home with Sauza Hornitos - agave. Yum...last year at the county fair they had a booth, and when you buy the 14.00 drink it came with the shaker (plastic but cute). We then mimicked this same cocktail all year. It was at the Sauza booth. County Fair is coming up...and boy oh boy cannot wait.....gonna get that 1 FOOT LONG CORNDOG...been waiting an entire year. Last year I did not get it.
Okay Rossella try Stella Rossa...that's another Italian wine we had recently found and oh my god drinking that is like drinking sunshine...with it's slight efferesence...so yummy.
The wine I have in the fridge is a present of a local producer and it's not the best thing I have tasted in my iife, but you never refuse a present!
Rossella, I think we have to keep you of the bridge of the boat :)) We will let Bobbie do the navigating! Glad to know you and mom are safe.
Pirate - WEAR A SEATBELT. I losted a dear friend because she did not wear a seatbelt.
Jsomebody - We can all be annoying
Rip - Happy Birthday to Dad. When is or was your birthday.
Deefer - Everytime I went to post something I forgot to wish you a happy birthday. Happy Belated Birthday!
Bobbie - I love the ocean. I come from a seafaring family. And i cuss like a sailor!
Mom has been having a rough few days and sure enough it turns out to be a UTI. She new she wasn't feeling well, but got scared and swore it was something worse.
I have to run to the grocery and send money to a friend in need.
Have a good night my dear friends
Jen, If I wanted to climb the sidewalk on purpose I would never have managed to do it. Im glad my car is little, it it were a Limo I would be still there. Otherwise, that gentleman should have called all the men of the village to free my car.
My desk is full-full of little insect-sinners corpses. I shall have to remove tons of dead biomass in the next days!
BTW cuss means "to smoke cannabis"? I'm not sure
"Where's (insert name of pothead)?"
"Out back cussing up a storm. Yesterday was Sunday and he cussed all day. Woke up cussing. He didn't cuss this morning, and went to work but as soon as he got home out came the cussing. He'll probably cuss all night and pass out after eating everything in the house."
"Sounds like cussing can be expensive!"
"You said it! When we got married I didn't know he cussed like this! What with the cussing and the extra food I had to get another job!"
lovbob
Hope to cuss, smoke pot and drink all together very soon!
thank you for being part of our crew!! You are such a great voice and thank you also for your support!
love you my Italian little sister,
lovbob
And you are right we vote for them we pay em they can answer to us!