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:
Our mission is to help you live your life to the fullest - in your own home- under your own terms. At Rose’s Agency Home Care we cover all aspects of comprehensive senior care. In keeping with our philosophy, every client...
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WelbeHealth is a Program of All-Inclusive Care for the Elderly (PACE), full-service healthcare provider that helps you live your life healthy and happy, in your own home.
At Senior Helpers we are here to help anyone we can. No matter how big or how small the task-- our goal is to keep your loved ones safe, maintaining or enhancing their quality of life.
Premier Home Care is your family's trusted companion and the leader in providing affordable personal in-home quality care solutions and services for seniors and disabled individuals. Services can be provided 24 hours a...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
Sunset Healthcare Inc. is a company that specializes in providing a wide range of healthcare products and services, with a focus on respiratory and home medical equipment.
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Operated by a married couple that holds a Bachelor of Science in Nursing degree. Having the passion to significantly improve the lives of the people by serving them in a S.M.A.R.T. way and consistently implementing the...
We specialize in providing value-based, comprehensive care and coverage for older adults with significant needs so they can thrive in the homes they love and in the communities they cherish. Our high-touch, team-based...
Founded in 2020 by industry veterans. After 16 years of combined home care nursing experience across different aspects of the home care field, Prestige Home Care Angels' founders decided to start their own home care...
WelbeHealth is a Program of All-Inclusive Care for the Elderly (PACE), full-service healthcare provider that helps you live your life healthy and happy, in your own home.
WelbeHealth is a Program of All-Inclusive Care for the Elderly (PACE), full-service healthcare provider that helps you live your life healthy and happy, in your own home.
Senior Helpers of Long Beach is a family-run business founded by Julia LaPlount in 2019. Julia, her daughter and her granddaughter have all been inspired by their own personal caregiving experiences to serve seniors who...
Welcome to Minoru Home Care, Inc. You deserve to have the optimum level of health and comfort. Whenever life’s difficulties hinder you from achieving wellness, then we are here to provide you with home care services...
Perfect Fit Home Care is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Are you looking for a Los Angeles caregiver that you can depend on to provide your beloved family member with professional, thoughtful care? Fortunately, Homewatch CareGivers of West Los Angeles has nearly four decades of...
Meet the Compassionate Team at SYNERGY HomeCare of Santa Monica – Your Dedicated Partners in Exceptional Care. At SYNERGY HomeCare of Santa Monica, we’re not just a home care agency; we’re a team of caring individuals...
At Interim HealthCare of Santa Monica and Oxnard, we understand how important it is to have someone you can depend on when you or someone you love wants to stay at home to maintain the highest level of health and...
Find In-Home Care That’s Right for You - Companion Care - In-home companion care helps seniors stay socially active and engaged, with activities and attention that help provide a richer, more fulfilling...
Always Better Care HH is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Four Seasons Quality HH is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Affiliated Home Health Services Inc is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
High Quality Home Health Agency, Inc is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
California Home Health Specialist, Inc is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Metropolitan Home Health is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Active Care Home Health, Inc is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Apex Home Health Services is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Horizon Home Care, Inc is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Media Home Health is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Los Angeles Home Health Care is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cosmopolitan Health Services is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Fountain Home Health, Inc is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advantage Home Health Services is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Health Care Agency, Inc is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In memory of our mom, Livewell Private Care continues to provide the loving, professional and tender care that families have come to expect from our Livewell brand. Our focus is on hiring and placing the most qualified...
At Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations as...
HomeWell Care Services of Torrance, CA is a home care provider that services in Los Angeles, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We our licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Senior Helpers West Los Angeles was founded in 2005 and acquired by Ted Pappas in 2011. Ted was drawn to the mission of helping seniors in West LA live safely and independently in their own homes for as long as possible....
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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.