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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:
We understand that receiving care at home is a personal decision. At Harmony Angels, we’re dedicated to providing compassionate and high-quality care that allows you or your loved one to live life to the fullest, in the...
Thank you for choosing My Healing Angels, your primary source for companion and personal care services. We are dedicated to provide excellent services for all your home care needs. We strive to build personal...
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...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Home Instead Snellville offers individualized in-home senior care right in your neighborhood. Our trained, screened and bonded CAREGivers are serving Georgia communities with compassion and devotion.
Merriment Home Care, LLC, located in Jonesboro, GA, is a premier provider of home care services dedicated to offering compassionate and personalized care to individuals in the comfort of their own homes. Our team of...
Quality, trust and compassion are the foundations of Southern Crescent Care, LLC. Owned and operated by a registered nurse, our caregivers enhance the lives of seniors across the Atlanta area.
At A Gentle Touch Home Care, our mission is to provide compassionate and personalized support that enhances the quality of life for individuals needing home-based care...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Charlotte Web Private Home Care, LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ANALIA HOME HEALTH CARE SERVICES, LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At ABA Home Care Services, LLC, we understand that choosing a home care provider can be a difficult decision. That's why we are committed to providing the highest level of care and prioritize giving support to our clients...
Here at Believe and Evolve Healthcare, we care for your loved ones like our own. Providing personal and loving care for your family in times of need. We are here to make this process as easy as possible for the entire...
Assistance with bathing, grooming, personal hygiene, dressing, feeding, cleaning, medication reminder, transferring in and out of bed/chair, walking, and assisting with mobility.
INNOVATIVE NURSING SOLUTIONS OF GEORGIA, LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At A Mother's Love Home Healthcare, we started with the goal of providing the best home healthcare services to our clients. With over 1 year of experience in the industry, we have established ourselves as a trusted brand...
Rockdale Medical Center Home Health is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Leading Paths, LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Why choose Fleur Passionate Care for your home care needs in Conyers? Compassionate Caregivers: Our carefully selected caregivers are not just skilled professionals but also compassionate individuals who prioritize the...
Xclusive Care Services LLC is a non-skilled home care agency based in Conyers, GA, specializing in providing compassionate care and assistance to individuals in their homes. They offer a range of services designed to...
Research has shown that convalescence is more effective when care is delivered at home. That’s right, home care—not a hospital, not a nursing home, your home. That is why we at Amicus Home Care invite you to an...
Always Best Care combines national strength and standards with local accessibility and personal service. The team at Always Best Care Atlanta has your loved ones’ best interests at heart, and will ensure that exceptional...
D & D HOME CARE, LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARING AND LOVING HANDS LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Renowned Care LLC, GA is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
omise2Serve Health Professionals LLC specializes in providing top-quality homecare services. We connect compassionate caregivers with clients in need of assistance with daily activities, ensuring comfort and independence...
COMFORT HOME CARE SERVICES LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CATER HOME CARE is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Majestic Intl. Home care services is a home care provider servicing Metro Atlanta Ga. and it's surrounding counties. We provide quality, reliable, compassionate, cost effective care, Majestic Intl. is licensed, bonded...
Sensitive Home Care Agency Inc is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARE SHINE'S LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SYNERGY HomeCare of East Metro Atlanta is committed to serving you on a local and national scale. Our relationships with AARP and the Private Duty Homecare Association allow us to truly make a difference across the United...
Rogenia's PHC Services LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
LUCIENNE HOME CARE, LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We know firsthand the challenges facing many families today — caring for loved ones, sometimes hundreds or thousands of miles away, or even across town. Now there’s help. When you or your loved one needs help at home,...
At A Piece of Mind Personal HomeCare, our mission is to enhance the quality of life for our clients by providing compassionate and professional home care services. We are dedicated to delivering personalized care that...
SAS Loving Care Services is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Georgia Best Homecare LLC is a home care provider that services in Conyers, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Atlanta Senior Care Provides Peace of Mind We provide quality, affordable, non-medical in-home care for adults of all ages, including Atlanta senior care and rehabilitative care, so that adults can enjoy the best...
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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.