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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:
Home Matters Caregiving Philadelphia (Montgomery County), PA is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Formosity Support Services, LLC is a non-medical home health agency with over 10 years of experience providing compassionate and reliable care. They are dedicated to helping seniors and individuals with disabilities live...
Helping Angel Home Care LLC provides compassionate in-home service and solutions that enrich our clientss lives and help them achieve the highest possible level of independent living. We treat each of our clients with...
As we age, we will eventually reach that point where we only have little control over our mobility, our health and many other life circumstances that are tied with old age. Similarly, we experience these struggles when we...
Team Select Home Care provides compassionate non-medical support to help clients remain safe and independent at home. Services include personal care assistance (bathing, grooming, dressing), companionship, meal...
At FirstLight Home Care of BuxMont, we provide exceptional care so that your loved one has the support they need to enjoy the quality of life they deserve in the place they call home. We exist to help people have their...
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...
Vital Guardian Healthcare LLC is a home care agency based in Gilbertsville Pennsylvania that provides in-home support services designed to help adults remain safe comfortable and independent in their own homes. The agency...
Loyalty to Life LLC is a trusted home care provider serving families throughout Philadelphia County. The agency offers personalized non-medical in-home support, including assistance with daily living, companionship,...
Just as growing older can allow for a more relaxed lifestyle, it can also present new obstacles and challenges. At Haidar Home Care LLC, our clients have peace of mind knowing that we are dedicated to their satisfaction...
At Amada Chester County, we strive to provide the highest quality of care with a sense of warmth, kindness and compassion. Each member of our team is committed to your loved one because to us, they are family. We take...
Compassionate Assistance is a family-owned, non-medical home care provider. We are dedicated to providing the highest quality, compassionate in-home personal care to families with loved ones that are chronically ill,...
Amada Senior Care of Dresher, PA is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Good Spirit Caregivers is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Euphoric Living Home Care LLC, Compassionate In-Home Care Services At Euphoric Living Home Care LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
AXION WORLDWIDE LLC is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Reliance Home Health Care is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kali Kare Homecare, LLC is a home care provider that services in Blue Bell, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Mission To encourage hope and support, to maintain health and well being. Through medical practices, knowledge of new technologies, training and thorough research, we provide quality service. In Wendell’s Room...
We at Griswold Home Care Referral Service realize that every home-care situation is unique and that having the correct type and amount of care for your loved one is what provides our clients with peace of mind. Whether it...
R.I.G.H.T.S! was founded on the principle that health care gets better when consumers have a team at home—the place they most want to be. From the Licensed Clinical Social Worker, Speech-Language Pathologist, Registered...
Our One You Love Home Care location in Ambler, Pennsylvania delivers private senior in-home care to your mom, dad or other loved one so they can remain in their own home living comfortably and independently. One You Love...
We understand that not one care plan fits all. Daily services can include anything from meal preparation, hygiene, cleaning, and supervision. We will take the time to get to know you and develop an individualized care...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
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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.