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.*
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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:
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 in Cleveland,...
Eagle Pass Home Health Services LLC provides compassionate, non-medical in-home care that helps older adults remain safe, comfortable, and independent in the place they know best—their home. Services include personal...
Our in-home senior care starts with a clear understanding of who you are and what we can do to make your life a little easier and a little brighter. Whatever services you need and whenever you need them – for yourself...
Cornerstone Caregiving is a senior home care provider in Cleveland, Ohio that is trained and ready to help your loved one today. Our leadership team holds decades of at home senior care expertise in the home care...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Care With Love is a compassionate home care provider dedicated to improving the quality of life for seniors and individuals who need assistance while remaining in the comfort of their own homes. The agency focuses on...
Senior Helpers of Greater Cleveland has been caring for seniors throughout Cleveland's West suburbs for over 10 years. We offer tailored services to meet the individual needs of your loved one. Our care services range...
At Shalon's Caring Hands our commitment is to transform the way in-home care is experience by blending compassion, excellence, and truly personalized support. Our mission is to help individuals live safely and comfortably...
Hummingbird Home Care is a family-owned, independent provider of in-home care in Cleveland, Ohio, dedicated to treating every client with dignity, respect, and compassion. Their personalized approach focuses on helping...
At All In One, we treat your family like our own. I started this agency because I believe that every senior in our community deserves to be heard, wanted, and independent. We aren't just a service provider; we are your...
At Homewatch CareGivers of Stow-Twinsburg, we believe that care is about more than helping with daily tasks—it’s about creating meaningful connections, supporting independence, and improving quality of life. Our franchise...
Mother's Best Home Healthcare LLC is a trusted home care provider serving the Cleveland area, dedicated to delivering compassionate, personalized care that helps seniors and individuals with disabilities remain safe,...
Compassionate In-Home Support for Everyday Living Non-medical home care services designed to help seniors and families feel safe, supported, and comfortable. Right where they belong.
Right at Home Cleveland Southwest provides personalized in-home care that helps older adults live safely and independently at home. From companionship and personal care to specialized dementia support and respite...
Providence Home Health Care, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Protem Homecare is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors Helping Seniors is a non medical home care company. We provide a wide array of services such as companionship, meal prep, homemaker services, Alzheimer/Dementia care, 24/7, overnight care, yard work and handyman...
Our Mission and Values “As a member of The Senior’s Choice, a leading companion care service provider, our mission is to ensure a better quality of life for our elderly clients and the families by providing...
Xcel Healthcare Providers, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Chs of Greater Cleveland, LLC is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
McCray's Staffing LLC is a private home care assistance company that provides quality in-home care to those in need. We are also certified for MRDD clients for home in home care.. All Services are performed by State...
Mr Homecare Of Cleveland Ohio, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Classic Medical Staffing is a home care provider that services in Cleveland, OH. 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...
Imani Home Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Eldercare Services Institute Home Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
RX Home Healthcare, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nationwide Healthcare, LLC is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Parma Community General Hospital Home Health is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Centric Care Services LLC is a Non-Medical Private Duty Home Care Agency; with the mission of being the most client centric home care service available to clients. Centric Care Services LLC is an independent...
Personal Home Health Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
University Hospital Home Care Services, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Priority Home Health Care, Inc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Visiting Nurse Association of Cleveland is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Arcadia Home Care & Staffing is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caregivers You Can Trust Feel better in the comfort of your own home. We specialize in care and daily living assistance to an array of individuals. Whether you need daily or weekly assistance due to aging, illness,...
As seniors grow older, completing daily tasks like showering and enjoying activities such as visiting Lawrence Grist Mill in Brook Park, OH gets harder without someone by their side. Unfortunately, many older Americans...
Just Like Family Home Care, Llc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Spectrum Home Health Care Llc is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Wyandotte Home Health Care Company is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alpine Home Health Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Arcadia Health Care is a home care provider that services in Cleveland, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior care services from Home Instead® help to enhance the aging experience by providing practical support at home with a human touch. Our professional CAREGiversSM immerse themselves into wherever home is to assist with...
Big Heart Home Health Care LLC is focused on providing high-quality service and customer satisfaction - we will do everything we can to meet your expectations. We provide service in Cleveland, Youngstown, Ashtabula,...
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...
Medicaid/Medicare certified Home Health Agency located in Cleveland and serving the needs of patients in the Greater Cleveland area and surrounding counties. All our employees undergo a background investigation process...
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,...
At Senior Helpers, we are here to help anyway we can, no matter how big or how small the request. Our owners are the husband and wife team of Michael and Lynn Jones. Our team knows these aren't just clients, but cherished...
At BrightStar Care Cuyahoga West, we believe that caring is more than just a job– it’s a way of life. That’s why our caregivers mean so much more to the people, families, and organizations they serve.
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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.