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.*
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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:
Alpha Homecare LLC, Compassionate In-Home Care Services At Alpha Homecare LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence. Our...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
Our Mission To provide compassionate, professional home care that empowers individuals to maintain their independence and dignity while giving families peace of mind.
It is our mission to provide our clients with exceptional home care services and achieve the optimum wellness they deserve. Our mission and vision will be achieved through the application of our core values.
At Golden League Care LLC, we believe exceptional care feels like a champion by your side. Our experienced caregivers offer tailored assistance—from daily living support and meaningful companionship to specialized...
At Home Helpers® Home Care we offer personal care & companionship care. We assist with elderly care and the basic activities of daily living like hygiene, cooking, mobility, errands and light housekeeping to help your...
We know there’s no place like home. That’s why we bring the highest quality of care right to your front door. With a personalized care management approach and a dedicated team of compassionate caregivers, you can expect...
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
When you and a loved one in your life require care assistance, Executive Home Care is ready to lend a hand. Find out more about the expert and compassionate senior living care that is offered in the comfort of one’s own...
Acti-Kare of Tustin, CA provides tier one in-home Personal care. Our trained, insured, and bonded caregivers will provide your loved one with in-home personal care services across a broad range of categories. As we age,...
Home Care Providers is a licensed, accredited home care agency with over 30 years of experience delivering compassionate, personalized in-home care services that help seniors and individuals maintain their independence...
Being the family caregiver can prove to be a challenge. You may feel burnt out or just overwhelmed trying to manage your own life while helping your loved one. If you are supporting someone through a medical crisis or are...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
In-Home Care Overview: Senior Helpers – Costa Mesa, Newport, Fountain Valley, Santa Ana, Orange CA At Senior Helpers, we are here to help anyway we can -- no matter how big or how small the task.
Home Helpers Home Care of Orange Coast is more than an in-home health care agency – we’re your extended family when family can’t be there. We’re a locally owned, trusted provider of quality, compassionate in-home care 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...
Abiding Home Care LLC of Laguna Hills, CA proudly provides non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and...
President and CEO of Interim HealthCare of Irvine, Khushbu Dadlani, has spent the past 10 years caring for and educating preschool children. Faced with the challenges of caring for her own parents-in-law, Khushbu’s...
As a provider of quality home care services, we are dedicated to helping aging individuals or with a disability or chronic illness to live independently at home. We offer long-term, short-term, and around-the-clock care,...
OPTIMAL SENIOR CARE SOLUTIONS is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Strive Home Care LLC is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
If you are currently caring for a loved one that is having challenges living independently, we understand how difficult it can be. With the right kind of help, it’s possible to improve their quality of life so they can...
Healthways Home Health Services, Inc is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We’re a family-owned franchise boutique located in the heart of Orange County. We believe it’s time the in-home care experience became more personalized, positive, and powerful. We bring our own family’s experience as...
At Home Personal Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors R Special is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elite Health Group offers the ideal home care solutions for Orange County residents who want to maintain their independence and dignity by continuing to live in the comfort of their own homes. Let our highly experienced...
HomeLife Partners Combines Geriatric Care Management with In-home CareAfter years of managing her own family’s home care needs, Karen Galas, founder of HomeLife Partners LLC, decided to start her own company and do it...
Primecare Plus, Inc is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cerna Homecare - Irvine is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Absolute Health Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Stat Home Care serves clients in Southern California with quality home care services. Our primary purpose is to make life easier for individuals who are in need of constant supervision and assistance. With our services,...
Care America HomeCARE is a provider of home care in Orange County California that offers assistance to individuals with daily living and companionship. Our team of dedicated and compassionate professionals is comprised of...
At Salus, we know there’s no place like home. We also understand that aging presents challenges for the entire family. That’s why Salus was founded: to provide solutions to the complexities aging presents. Our caregiver’s...
Live life your way in the comfort of home with Home Helpers Home Care of Orange Coast! From a few hours a week to 24/7 care, we’ll tailor a personalized home care plan to fit your lifestyle with the flexibility to change...
Comfort Keepers of Irvine, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Operated by a married couple that holds a Bachelor of Science in Nursing degree. Having the passion to significantly improve the lives of the people by serving them in a S.M.A.R.T. way and consistently implementing the...
365 Home Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TheKey Corporate - Orange County, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Prime Care Quality Home Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
After serving in home care for years, Ronel & Rozen Ocampo felt they could offer their BEST CARE for families if they were in charge of their own Caregiver staff and were "hands-on" in their dedication to their family...
Cerna HomeCare - LA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When you or your loved one need help at home, turn to FirstLight Home Care of Irvine. We offer complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just...
As a family owned, not for profit organization, Canaan Home Care is at the forefront of the home care industry. Canaan has been a partner of the State of California for over 25 years, together, raising the home care...
Acti- Kare of Irvine provides senior care and home care services in the following locations including Irvine, Newport Beach, University Park, and Northwood in California.
At Golden Years Home Care Solutions Inc – San Diego, our mission is to provide compassionate, personalized, and dependable home care services that empower seniors and individuals with disabilities to live safely,...
At Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations as...
Assisting Hands is dedicated to providing reliable, compassionate home care that honors the dignity of each of our clients. Our team of highly trained professionals is committed to providing the same level of care we...
At Senior Helpers, we are here to help anyway we can -- no matter how big or how small the task. Our owners, Sandy and Hector Muñoz, know personally what it's like for the people in need of care and the toll it takes...
Golden Age Companions is dedicated to improving the lives of seniors and others who have reached the point in life where they need companion care. We’re dedicated to providing personable, hands-on, and integrated caring...
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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.