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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.
✔
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:
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To provide professional, compassionate and personalized home health care services to our clients that empower individuals to maintain their independence and improve their quality of life. We are committed to delivering...
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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...
Inclusive Community Home Care is a licensed and professional home care agency that was founded in Frisco, Texas. At Inclusive Community Home Care we believe that all people in our community deserve to be cared for no...
At Dallas Texas Caregivers, we understand that as one ages, completing daily tasks and activities may become harder to do. Day-to-day living may become particularly difficult, especially for seniors who are suffering from...
We combine a country club lifestyle with gracious decor, hotel style amenities, and a myriad of opportunities to stimulate your mind as well as your body. We remove the worries and concerns of day to day life while...
ALMAZ PERSONAL HOME CARE SERVICES LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Prayers Home Health Agency LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aquinai Home Healthcare Inc is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Machris Home Health Services Inc is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our in-home care services provide the daily support adults need to live a life of dignity with as much independence as possible in North Dallas and surrounding areas. We understand your loved one deserves more than having...
Next Phase Home Care LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
COMPLETE VISIT is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Always There Home Care Frisco TX is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Home Helpers® Home Care, we want to be the extended family for your aging loved ones when you aren’t able to be there. It’s our mission to make life easier for our clients by providing the same exceptional care that we...
Ansah Healthcare is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Temple Healthcare Services is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Favorite Home Health Care LLC is a home care provider that services in Frisco, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A LEGACY HOME CARE LLC is a home care provider that services in Frisco, 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....
Comfort Keepers is the leading provider of customized home care services for Carrollton, Coppell, Lewisville, Flower Mound, Farmers Branch, and Addison. Our independently owned and operated Carrollton office provides...
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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.