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:
Elevare Home Care, LLC provides non-medical home care services focused on helping individuals live safely, comfortably, and independently at home. These services do not include medical or clinical care, but instead...
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.
Our in-home companions are here to care for all of your family’s non-medical needs. Our experienced caregivers prevent loneliness by providing company and assisting with daily activities like bathing, shopping, and...
Charlotte Web Private Home Care, LLC is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Entegrity Homecare Solutions, Inc is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Crown Health Services is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Whether providing short-term assistance or long-term support, our team is committed to enhancing well-being and fostering peace of mind for both clients and their families.
At Be Well Health Solutions, Inc, we believe every individual deserves to age with dignity, comfort, and personalized support. Located in Jonesboro, GA, our locally owned and operated home care agency is committed to...
Healthsource Agency is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Founded in early 2016 by Ivana Johnson, we focus on each individual and their unique needs; we provide them compassionate care in their preferred surroundings. At A.I.D. Home Care, we provide non-medical home care...
Comfort Integrity Care Agency LLC is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Williams Private Home Care, Inc provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical support, and...
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...
AFRAM HEALTHCARE SERVICES is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Saving Grace Private Home Care is a trusted, locally owned home health care agency based in Hoschton, Georgia, dedicated to helping seniors maintain their independence and dignity within the comfort of their own homes....
Janella's House of Nursing is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Everyday Blessings Personal Care is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Joycee Love Home Care is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ideal Home Care of GA is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
EPIC MEDICAL SERVICES, LLC is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ABLUx Healthcare, LLC is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ComForCare Home Care Clayton/Henry County, GA is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
COMFORT HANDS HOME CARE, LLC is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
INTEGRITY GARDEN HOME CARE LLC is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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 Hands Home Care LLC is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The World's Heart Private Home Care is a home care provider that services Jonesboro, GA 30238. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal...
M AND A HOME CARE LLC is a home care provider that services in Jonesboro, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our team of experienced and highly trained caregivers are dedicated to ensuring comfort, safety, and dignity for each client. We understand the unique needs of every individual and work closely with families to tailor...
Shontella's Caring Hearts is a compassionate home care agency dedicated to providing personalized, high-quality care to seniors and individuals with special needs in the comfort of their own homes. Our skilled caregivers...
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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.