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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.
✔
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:
Herewith, Inc. is a nationwide platform connecting families with caregivers for in-home non-medical assistance. In Texas, they offer flexible senior care services through a network of "Caregivers" who assist with tasks...
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Whether it’s helping with chores, providing medication reminders, or meal assistance, ComForCare gives you the freedom to focus on spending quality time with your family members and loved ones.
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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...
Hello! We are Marshall & Kacy Oden and we would like to welcome you to the Griswold Home Care Office of Garland, TX. We independently own and operate the Garland office and are very proud to offer affordable, high...
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Assisting Hands Home Care provides professional non-medical home health care services, allowing our clients to remain safely and comfortably in their own homes.
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Life is in constant motion. From the time we smile our first smile, ride our first bike, find our first home or embrace our first grandchild, it just keeps moving. And a moving life is a full one. But sometimes, life can...
At Home Halo of Plano, we believe care shines brightest when tailored with heart. Our dedicated caregivers offer thoughtful, individualized support—from daily routine assistance to heartfelt companionship and personalized...
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FirstLight Home Care is the go-to home and senior care provider in Plano, TX! Our quality caregiving solutions are perfect for the elderly, those recovering from surgery, or anyone needing help with personal care or daily...
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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...
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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...
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Eric vanGoethem, Owner of Amada Senior Care Dallas, has made it his mission to help seniors live safely and comfortably for as long as they can in the comfort of their own homes. Eric deeply empathizes with families who...
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EHCS is dedicated to becoming a servant leader in the home care industry. We exist to enhance the quality of life for our clients and to promote independence and healing in the comforts of their home. Book an appointment...
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Good Shepherd Home Healthcare Agency is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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NB MED SERVICES is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ebt Home Health Services is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
H&A Home Care Agency LLC provides personalized in-home care services for seniors and individuals requiring assistance. Our compassionate caregivers support daily activities, promote independence, and enhance quality of...
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...
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...
Visiting Angels of Richardson, TX is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
There is no higher priority to our NolasHands Family than the safety of our clients and caregivers. We aim to keep all of you out of harm's way and to support you through this challenging time.
When you or your loved one need help at home, turn to FirstLight Home Care. We offer complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just needs a little...
Keystone Healthcare, Inc. is a home health agency based in Richardson, Texas. It provides a variety of in-home health care services, including skilled nursing, physical therapy, occupational therapy, speech therapy,...
Senior Helpers of Richardson offers companion care, personal care, and chronic disease care to seniors in the Greater Dallas area. We help you to decide what care service is best for your loved one and family and...
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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.