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:
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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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...
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Home Helpers Home Care of Boerne, TX provides compassionate, professional home care services for seniors and adults in Boerne, Canyon Lake, and surrounding areas. Through personalized care plans, experienced caregivers...
Home Helpers® Home Care is a in-home care service that provides top quality in-home care. Our Cared-4℠ program is a holistic approach to meet the four primary areas of need, helping your loved one stay safe and...
Since 1984, the founders of Preferred Care at Home have had the privilege of assisting clients improve their quality of life while still recognizing and maintaining their dignity and independence. Preferred Care at Home...
Alomega Home Health Care LLC-San Antonio is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors Helping Seniors® 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...
At Right at Home San Antonio, we understand that every person’s needs are unique. That’s why we tailor our in-home care services to fit each client’s individual lifestyle, preferences, and needs, helping them live...
e dedicated to enhancing the lives of our clients by promoting independence, dignity, and overall well-being. Our team of skilled caregivers strives to create a safe, supportive, and nurturing environment where seniors...
And Homecare Services LLC provides compassionate, reliable in-home support tailored to each client’s unique needs. Caregivers deliver personalized daily assistance and meaningful companionship—promoting safety,...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Our in-home care services provide the daily support adults need to live a life of dignity with as much independence as possible in Central and North San Antonio and surrounding areas. At FirstLight, we understand your...
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...
We are an in-home personal and companion care agency that has helped families all over Dallas and surrounding areas. We have a Personal Assistance Services License issued by the Department of Aging and Disability Services...
Here at Pampered Wellness Recovery Home, our mission is to provide compassionate, high-quality home care that empowers individuals to live independently with dignity and respect.
Scott and Megan Archer opened Senior Helpers of Canyon Lake because of their dedication to providing the highest level of home care and client service possible. Megan and Scott are perfect partners when it comes to...
CareCo offers a variety of services to meet each individual client where they need care the most. Our services are designed to supplement family support and medical care, providing comprehensive care coverage to our clients
Alpha Care Service LLC is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Americare In Home Care Inc is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Adoni Home Health Inc is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Access Home Health Agency of San Antonio, TX is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alomega Home Health Care LLC-Austin is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Good Home Health Care is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aidante Care is a trusted home care agency dedicated to providing high-quality, compassionate, and personalized care for individuals in need of assistance with daily living.
AA Care Services is a reputable home care agency located in San Antonio, New Braunfels and surrounding areas dedicated to providing high-quality in-home care and support services for individuals in need. With a strong...
24/7 Home Care Llc is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
About Acti-Kare Responsive In-Home Care Acti-Kare’s Mission The Acti-Kare mission is to provide quality care and companionship to seniors and others by offering a broad range of supportive in-home care services that...
At Affordable Venture Home Healthcare we are here to help individuals who require Home Healthcare needs, some level of medical attention to ensure their health and wellbeing. We offer a wide variety of home home...
Affinity Senior Care Of Texas LLC is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alpha Nursing and Therapy LLC is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All Your Home Health is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alamo Home Healthcare Inc is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AHOME HEART PROVIDER SERVICES LLC is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Plus Comfort Care, Inc is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amazing Grace Primary Home Care of San Antonio, TX is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Acts Of Kindness Homecare of San Antonio, TX is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All Your Home Health, Inc. is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Soft Hand Home Care LLC, Compassionate In-Home Care Services At A Soft Hand Home Care LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
Advocate Home Care is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alegria Primary Home Care, Inc of San Antonio, TX is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
CORNERSTONE CAREGIVING IN SAN ANTONIO, TEXAS We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in River City or in surrounding areas like Downtown,...
Access Quality Therapy Services is a home care provider that services in San Antonio, 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...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in River City or in surrounding areas like Downtown, Midtown, or Alamo Heights.
We understand the challenges that families are facing because we have lived those same challenges. We have focused our Home Care services on what matters most to families. Our goal is offer the best possible service for...
Cardinal Senior Care - San Antonio, TX is a home care provider that services in San Antonio, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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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.