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.
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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:
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Home Helpers provides professional in home supportive services that help seniors and adults remain safe and independent at home. Through their unique Cared-4℠ program, a Caregiver can assist with personal care and...
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At CHRISTY GRACE HEALTH CENTER INC, we focus on providing the highest standards of clinical care with compassion. We offer a variety of comprehensive healthcare services in the comfort of our clients’ homes. We provide...
B'Zoe Home Care Services of TX is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Helpers® Cared-4 program covers every need to keep someone independent and comfortable at home. Our services include Personal Care & Companionship, Nutrition and Well-Being, Safety and 24-Hour Monitoring and Wellness...
Reliable Homehealth Services LLC provides non-medical home care services focused on helping individuals live safely, comfortably, and independently at home. These services do not include medical or clinical care, but...
Assisting Hands Home Care – West Austin provides compassionate, personalized in-home support that helps individuals remain safe, comfortable, and independent in their own homes. With a strong clinical foundation rooted in...
We are a client first franchise. Our goal is to build lasting and meaningful relationships between caregivers and their clients. We are family operated and consider our caregivers a part of the family. Our caregivers are...
Core Values We live these core values every day, without compromise. It is what we believe in above all else as they guide our home care company and team members to help us achieve our mission.
At CareCo, we believe great care starts with genuine relationships. Inviting someone into your home is deeply personal, and we don’t take that lightly. Our team is built on caregivers who are not only experienced and...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in South Austin or in surrounding areas like Onion Creek, Rollingwood and Bee Cave. Our trusted...
Ronnie has passion for helping others in a time of need led him to the home care industry after 30+ years of leading teams in retail. After losing his father to a terminal illness, having grandparents in assisted living,...
Griswold Home Care for Pflugerville & Round Rock provides compassionate, non-medical in-home care designed to help individuals live safely and independently where they love. Backed by over 40 years of national experience,...
Home Matters Caregiving exemplifies these services by offering various options such as daily living support, hourly care, 24-hour care, live-in care, and overnight care services. These services are tailored to preserve...
K And J Sunshine Home Health Care Inc is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
C C Home Health Central Inc is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Are you exploring care options for a loved one or family member? Our home care services bring the convenience of an assisted living center to you, in your home, giving you the sole attention of a personal caregiving...
Journey Home Healthcare of Austin LLC is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
First Divine Home Healthcare Agency Inc is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Texas Home Therapy of Austin LLC is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gilead Home Health is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors Helping Seniors - Hill Country at Austin, TX is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interim Healthcare of Austin is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Inhome Care Inc is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Robinson Creek Home Health and Hospice is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
First Choice Childrens Homecare is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Rescare Homecare Tangram is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Theracare Home Health Of Austin Llc is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Maxim Healthcare Services Inc is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hill Country Home Health is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The Home Option is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentiva Health Services is a home care provider that services in Austin, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Oliver Home Healthcare Agency is a home care provider that services in Austin, TX. 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...
Preferred Care at Home of North Austin and Williamson County is locally owned and operated, providing caregiving services including companionship, medication reminders, hygiene assistance, light housekeeping, meal...
As a Premier Home Health Medicare and Medicaid Provider, we provide comprehensive health care services in the comfort of our clients’ homes. Our vision is to promote high-level wellness for the clients we serve.
RedBud HomeCare Services is a small, family-owned homecare agency that has the privilege of providing care that is reliable, dependable, and hands-on. We are here to serve the needs of Seniors and their families who have...
Our in-home care 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 compassionate care in the...
Patrick Murphy, owner of Amada Senior Care Austin, Texas has had recent senior care experiences in his own family that have reaffirmed his commitment to providing the highest quality of care services for his clients in...
We take pride in serving Central Austin and its surrounding areas. Our dedicated caregivers not only provide exceptional in-home care services, but also create meaningful connections by learning their preferences and...
Life is so much more than a to-do list. It's a series of moments with the people we love, making memories that make up a lifetime. BrightStar understands this, and is committed to making more of those moments possible in...
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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.