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:
HomeWell Care Services of Ft. Worth, TX is a home care provider that services Fort Worth, TX 76115. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our caregivers deliver high-quality personal care with the sincere intention of preserving a secure and pleasant living environment for their charges. Our care team members take great delight in ensuring that your loved...
Senior Helpers - Irving, TX is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When the time comes that extra care is required, whether due to age or health condition, many people prefer the familiarity and comfort of their own home. At Homewatch CareGivers®, we believe that good care should not...
Life is Better with Villi of Dallas, TX At Villi, we believe “It takes a village,” and we’re here to be that village for you and your loved ones. Our mission is to bring comfort, joy, and a helping hand to your daily...
Stephen Conway opened Senior Helpers Fort Worth in 2013 due to his commitment to delivering the best possible in-home care to seniors in the Greater Fort Worth community. After winning a battle with cancer, Steve was...
At Home Helpers Home Care of North Richland Hills, we recognize the profound impact of heartfelt, professional in-home care on our elderly and differently-abled community members. Our team is dedicated to enriching the...
At Care Mountain, we specialize in elder care at home. We take the time to understand every individual’s unique care needs and develop a personalized multidisciplinary care plan that involves experienced caregivers,...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Keller or in surrounding areas like Watauga or North Richland Hills.
At Homewatch CareGivers of Keller Grapevine, we understand the importance of finding a reliable and trustworthy caregiving provider for your loved ones. Whether you’re an elder adult or someone of any age with a health...
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,...
Comfort Keepers of Trophy Club, TX is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ComForCare Home Care of Irving, services and compassionate caregivers help older adults live independently in their own homes and continue to do all the things they love. We do not just assign caregivers to a job. We...
Comfort Keepers of Fort Worth, TX is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Accolade Home Care is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ssq Home Health Care Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Access Home Healthcare Services is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
IN Home Care is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Grandcare Home Health Llc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home is an in-home care and assistance agency, providing quality senior and disabled persons care since 1995. We provide trained, insured and bonded caregivers for a variety of caregiving needs. Whether it's for...
Nursefinders of North Texas is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Healthsouth Tarrant County Home Health is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carepath Home Health Network is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Fulford Family Home Health is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a family-owned home care agency with a mission to change the way the world ages. Our passion for assisting families with loved ones comes from our experiences as family caregivers. We opened our business with a...
Thunder Home Health Services is a locally owned and operated non medical in-home care assistance. Thunder Home health Services is committed to providing cost effective personal care to elderly and disabled persons with...
Finding caregivers who care. Champion Caregivers has been licensed by the State of Texas for over 2 years and provides non-medical companion/ homemaker services to seniors, those recovering from surgery, new and...
Caring Senior Service is a trusted homecare choice for seniors and their families in the area. Read more about our homecare services for this area. Caring Senior Service offers services, education and safety care...
Cardiovascular Home Care Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Southwest Home Health Services is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amedisys Home Health of Fort Worth is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Health Masters Homecare Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
"Let us surround your loved one with all the care and compassion they deserve" We are a local, owned home healthcare company that delivers one-on-one personal in home care assistance to Seniors and Disabled...
Ccb Healthcare System is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Assisting Hands Home Care® grew out of a desire to provide seniors, and others needing non-medical assistance at home, with the option that most people prefer – to remain independent, safe and comfortable in their own...
Encompass Home Health Of North Central Texas is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are committed to providing high quality, client-centered and affordable Home Care services to our clients to assist them to lead dignified and independent lives in the comfort and safety of their own homes. Their...
Available Home Care Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Quality Home Care can provided exceptional care for your loved ones. Home care allows your elderly parent to stay in their home and receive medical care for a health condition or assistance with daily tasks. Our home...
Universal Health Services is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Guardian Health Care is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Southwest Home Care LLC is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In Home Care is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Maxim Healthcare Services Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Girling Health Care Inc is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Encompass Home Health of North Central Texas is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our caregivers and personal assistants help overcome challenges and make home an even better place to be. We include everything from specialty senior care, Alzheimer’s and Dementia care, personal companion services,...
Renew Home Health is a home care provider that services in Fort Worth, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
C & C Caring Hands is proud to provide a high quality level of customer service, medical experience, and commitment to health and wellness to all our patients. Our experienced professionals put your healing needs first....
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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.