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:
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Right at Home Pelham provides a range of in-home care options for seniors and adults with disabilities. Don’t think of our services as one-size-fits all. We know everyone’s needs are different, so our care plans are...
Since 1971, Helping Hand Services has been serving Alabama families by providing compassionate, high-quality home care. We are a locally owned and operated home care agency and one of the oldest such services in the area....
Right at Home Gardendale provides a range of in-home care options for seniors and adults with disabilities. Don’t think of our services as one-size-fits all. We know everyone’s needs are different, so our care plans are...
Right at Home Birmingham offers special education and training for our staff regarding Stroke recovery, Hospice care, Cancer care and many more special circumstances. Right at Home Birmingham offers free in-home...
Right at Home Birmingham East provides a range of in-home care options for seniors and adults with disabilities. Don’t think of our services as one-size-fits all. We know everyone’s needs are different, so our care plans...
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,...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
Lena's Passionate Care is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Virginia Sitter's Service is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HomeWell is not your average home care agency. With innovative Signature Programs, highly personalized and specialized services and a culture that prioritizes your peace of mind—you can count on us to provide exceptional...
A leading in-home senior care company that has been trusted for over a decade, Acti-Kare, provides in-home elderly care to thousands of individuals every year and has constantly been ranked a leading senior and elderly...
Amedisys Home Health Lakeshore of Birmingham is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Able Homecare of Birmingham is a home care provider that services in Birmingham, AL. 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...
Touching Hearts at Home offers an array of home care services for seniors, people living with medical conditions or disabilities, those in transition from hospital to home, and anyone over the age of 18 who can benefit...
Gentiva Health Services is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Cornerstone Caregiving, we are proud to serve Birmingham, AL and its surrounding areas, offering compassionate in-home care for your loved ones. We take the time to get to know each client individually, ensuring their...
Intrepid USA Healthcare Services is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Over the years, Dailyn Caregivers have remained the most preferred non-medical caregiver of choice for families. Our skills and ability to offer comprehensive and practical solutions for day-to-day challenges has...
Interim HealthCare of Birmingham, AL is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
While Accessible Home Health Care began with the intention of helping the elderly age in their own homes, we've grown exponentially over the past twenty years! Our home health care services can assist your family at any...
Gentiva Health Services is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comforting Hearts Personal Care - Birmingham, AL is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Preferred Care at Home of Greater Birmingham is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Preferred Care at Home of Birmingham, AL is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors Helping Seniors - Birmingham, AL is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors 1st Home Health is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission in to provide our clients with the most trustworthy, loving, affordable, and accountable care experience ever. Also, provide compassionate care and extraordinary service.
ATC Healthcare Services, LLC is the leading staffing provider of readily available nurses (LPN and RN) for the north and central regions of Alabama. We are responsive and have the largest free standing pool of reliable...
Here at All Saints Home Health Care, we pride ourselves on coming up with innovative ideas that let us better serve our clients. We’re problem-solvers, innovators, and offer a complete range of services designed to meet...
Angel of Mercy ElderCare, LLC is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When it comes to caring for your loved one, you want the very best home care, respite care or senior care possible. FirstLight Home Care of Birmingham delivers individual and compassionate home care – the same kind of...
Family Private Care, LLC is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ameriCARE Birmingham believes it’s time the in-home care experience became more personalized, positive, and powerful. We bring our own experience, compassionate caregivers, and the industry’s best communication tools to...
T.T Hands On Care LLC provides very hands-on care to families. Latisha, owner and founder, provides free consultation to help you assess your care situation and offers recommendation on what additional services would be...
All About Care LLC is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Send Me an Angel Sitters, caring for your senior loved one is the top priority. Serving families in the Birmingham, Alabama area, we offer several services and care options to fit the varying and changing needs of...
Visiting Angels of Anniston, AL - DUPLICATE is a home care provider that services in Birmingham, AL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We provide high quality, dependable non-medical in-home care that allows individuals to continue to live life to the fullest at wherever they call home. Horizons Private Duty Care is a privately owned Alabama corporation...
Len Everts, owner of Amada Senior Care Birmingham, believes that our elders deserve our respect, gratitude and the highest level of care available. This is what the Amada Senior Care Birmingham team provides to its...
We provide non-medical home care services and dementia care for older adults, seniors, and their families with medical conditions and/or disabilities throughout the entire Birmingham, Alabaster, and Pelham areas. Our...
Since 2000, we have served Jefferson County and the greater Birmingham area with excellence in home care. We are a locally owned company dedicated to improving the lives of our clients with quality in-home care. Choice...
Heart to Home has a small group of reliable, experienced CNAs, who are also dementia specialists (if that is helpful), CPR certified, vaccinated caregivers to provide individuals with companionship (engagement activities...
Your Choice Senior Care provides services and care for those who choose to remain in their home. We can relieve the pressures and demands on you and your loved ones to help you live as independently as possible in the...
Home Helpers In-Home Care Services is more than an in-home health care agency: we are your extended family when family cannot be there. We are locally owned and a trusted provider of quality, compassionate in-home care....
ComForCare Home Care is a premiere home care provider specializing in dementia care and chronic conditions serving Birmingham and surrounding areas. We have a personalized approach to home care. We understand that...
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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.