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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:
Our team of caregivers assists with age-related duties that grow increasingly challenging for those who prefer to stay in their homes. No other home care service in the region gives the same degree of individualized and...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
Anchored Care LLC is a compassionate home care service dedicated to providing personalized, high-quality care for seniors in the comfort of their own homes. Our trained caregivers offer assistance with daily activities,...
We live our values authentically. Every action we take supports the best outcomes for our clients, each member of our team takes ownership in delivering on the care and commitments we have made and we build meaningful and...
Welcome to Quality Homemakers, your trusted partner in non-medical home care since 1986. For over 30 years we have been dedicated to providing Companion, Homemaker, Hands-on Care, and Live-in Support as well as ELS...
There’s a reason why Unity Home Care LLC, is a leading provider of homecare in Farmington, Connecticut, and that’s simply because we truly care for you! Elderly, injured, ill, and the disabled—we make every high-quality...
Whether providing short-term assistance or long-term support, our team is committed to enhancing well-being and fostering peace of mind for both clients and their families.
Invina Home Care provides compassionate, dependable non-medical home care services designed to help seniors and adults maintain comfort, safety, and independence in their own homes.
Our team will be able to assist with your loved one’s non-medical care and can help them avoid having to go to a nursing care facility. We believe that your family member should live their remaining years with dignity and...
With Nissi Agency you can entrust your loved ones to our experienced management and dedicated staff, who will go above and beyond to ensure that your loved one receive the best care.
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...
Founded on the principles of dignity, respect, and personalized care, we provide high-quality non-medical assistance to seniors, individuals with disabilities, and those recovering from illness or surgery. Operating from...
At SENIOR HELPERS of Stamford, CT we are dedicated to supporting families in our community with personalized care, no matter how big or small the task. Our mission is simple: to keep your loved ones safe while maintaining...
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...
FirstLight Home Care of Western Ct. is the business to turn to when you or a family member needs non-medical homemaker or companion care services at home. Our homemaker services include assistance with activities of daily...
At Petals Home Services, where we embody more than just a care service – we're a compassionate team of dedicated nurses who are deeply invested in our mission of delivering exceptional patient care. Our approach is...
Our Mission is to provide our clients with options, promote independence, embrace quality of life but more importantly provide a safe space for our seniors, veterans and people with disabilities to participate. With our...
Amada caregivers are compassionate individuals trained to provide personal assistance to seniors and other individuals in need. They offer physical and emotional support, ensuring the well-being and comfort of their...
Greenwich HomeCare is a locally owned and operated non-medical home health care agency dedicated to providing the highest quality home health aides. We are a licensed, bonded, and insured agency serving Greenwich,...
Home is where you experience the greatest sense of comfort and where you desire to be when you or a loved one require top-notch, empathetic support for your requirements.
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
OUR FOCUS: • Dependability of Service • Continuity of Caregivers • Peace of Mind for the Family • Quality of Life for the Client • Independent Living in the Home OUR SERVICES: • Companion Care - For our basic...
ComForCare Home Care - Stamford, CT is a home care provider that services in Stamford, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Solace Care is a home care provider that services in Stamford, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Patient Care, Inc. has been providing home care services for more than twenty-five years. Our office is licensed as a Homemaker-Home Health Aide Agency by the State of Connecticut Department of Public Health. We are also...
SYNERGY HomeCare of Stamford, CT is a home care provider that services in Stamford, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elder Care provides comprehensive home care services in New York, placing rigorously trained Aides in patients' homes under the supervision of experienced Geriatric Care Managers. Each patient receives weekly visits from...
Vn Hospice Care Of Southwest is a home care provider that services in Stamford, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At personalized Care at Home LLC, we are committed to helping our clients in the comfort of their home environment with personalized home care services that suit their needs and create a positive experience for our...
At BrightStar Care of Stamford, our local home care team is available to you and your family 24 hours a day, 7 days a week no matter what care you need. We pride ourselves on providing the highest quality of in-home care...
We understand the challenges of our Senior Citizens, Disabled, Vulnerable and Sick ones in the community. That is why we customize and personalize your Home Care experience with high quality care and passion using very...
Grace Home Care LLC is a home care provider that services in Stamford, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elder Care Homecare - Stamford is a home care provider that services in Stamford, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We offer independent living home care services built on four tenets: trust, skill, compassion, empathy. This holistic approach to the care needs of our clients strives to meet and exceed the needs of the whole person....
Personalized Home Care Ltd of CT is a home care provider that services in Stamford, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a non-medical home care agency based in Norwalk, Connecticut. We are dedicated to providing the best quality home care for you or your loved ones. Whether you are an aging individual who is in need of a little more...
At Companion Services Inc, we understand how crucial it is for you and your loved ones to continue living a pleasant and satisfying lifestyle at home. We are dedicated to making your life easier and more pleasurable with...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
Compassionate and reliable home care professional dedicated to supporting clients with dignity, respect, and personalized attention. Experienced in assisting with daily living activities, mobility support, medication...
Grace Home Care, LLC is a home care provider that services in Stamford, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Stamford, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are more than just a homecare provider, we are a dedicated team of compassionate professionals whose mission is to help individuals live longer, healthier and happier lives by delivering exceptional services to our...
Endurance Home Care is a non-medical Home Care Agency in Connecticut. Our mission is to improve the quality and duration of life for our clients while providing enriching opportunities for our Care Professionals. We...
Giving Hearts Home Care provides assistance with activities of daily living such as bathing, dressing, meal preparation, housekeeping, laundry, med reminders, ambulation, appointment transportation, and other tasks. Our...
Whether due to a temporary situation such as recovering from illness, injury or hospitalization or something longer-term such as the challenges of aging or a disability, including senior, elder or respite home care,...
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...
Acti-Kare of Stamford is a home care provider that services Connecticut. Home care services allow seniors to remain safely in their own home while receiving assistance with personal care and other daily tasks.
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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.