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:
Cornerstone Caregiving is a senior home care provider in Central Philadelphia that is trained and ready to help your loved one today. Our trusted caregivers can start care right away; no deposit or contract is required....
Attentive Home Care is a licensed home care agency that was founded in 2010 to support seniors and individuals with physical and intellectual challenges who are dealing with sickness at home, recovering from an illness,...
Formosity Support Services, LLC is a non-medical home health agency with over 10 years of experience providing compassionate and reliable care. They are dedicated to helping seniors and individuals with disabilities live...
Caring for older adults is our passion and specialty, serving older adults for over 20 years! NursePartners is founded, owned, and operated by Angela Geiger, Registered Nurse and Certified Dementia Practitioner. We...
Golden Point Home Health Care Inc. is dedicated to providing high-quality, compassionate care that empowers individuals to live safely and comfortably in the place they call home. Our team of skilled professionals...
Companionship is key to a trusted relationship with our caregivers. We are committed to providing high quality, client-centered and affordable Home Care services to our clients to assist them to lead dignified and...
Elder Home Care - Philadelphia, PA is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Senior Helpers of Greater Philadelphia, we deliver dependable in-home care tailored to your family’s needs. We help adults live safely and independently—right where they’re most comfortable: at home. Whether you need...
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance the quality...
National Senior Home Care provides trusted personal and companion home care services that help older adults live safely, comfortably, and confidently in the familiarity of home. Families throughout the Toledo area and...
A trusted and well-established organization with a focus on quality care. With over 25 years of experience in the healthcare industry, we are dedicated to providing personalized care for your loved ones. We maintain...
August Loving Home Care, LLC provides compassionate, non-medical in-home care. Our dedicated caregivers offer personalized support with daily living activities such as meal preparation, light housekeeping, medication...
Successful Aging Care is part of the Successful Aging Group, a trusted home care organization .Successful Aging Care Net is dedicated to empowering older adults to live vibrant, independent, and meaningful lives by...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Haven Homecare Inc. provides compassionate, dependable in-home care services that promote comfort, dignity, and independence. Their dedicated team delivers personalized support to seniors and individuals in need,...
Team Select Home Care provides compassionate non-medical support to help clients remain safe and independent at home. Services include personal care assistance (bathing, grooming, dressing), companionship, meal...
Since 2011 Senior Helpers of Chestnut Hill – Philadelphia is the premier provider of senior care, wherever your senior resides in Philadelphia, Montgomery and Delaware Counties. We provide a full range of senior home care...
Neighborly Home Care provides a comprehensive range of personal care services to assist seniors or anyone who needs help with activities of daily living, in their home or residence. We understand that maintaining your...
At Care for Me Home Health Services, our mission is to deliver compassionate, high-quality, and personalized home health care that promotes independence, dignity, and well-being for every individual we serve. We are...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
For those who wish to age peacefully or recover in a comfortable and familiar environment, HomeWell Care Services is committed to bringing you the highest quality of non-medical care and everyday support wherever you call...
Neighborly Home Care - Ardmore is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Vital Guardian Healthcare LLC is a home care agency based in Gilbertsville Pennsylvania that provides in-home support services designed to help adults remain safe comfortable and independent in their own homes. The agency...
Paramount Personal Care LLC provides compassionate and reliable in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, medical support, and...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
The entire professional care team at Amada Senior Care Philadelphia West Suburbs understands the importance of quality senior care that helps aging adults thrive and live safely and independently. Choosing the right home...
Comfort Keepers Mission Our mission is to provide our clients with the highest level of quality of life that is achievable. We shall treat each of our clients with the respect and dignity they deserve, as though we were...
Healthcare Stat Home Care (HCSH) is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Deer Meadows Home Health And Support Services, Llc is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Fairmount Homecare is a non-medical homecare company based in Philadelphia, PA. Our company is focused on delivering the highest quality caregivers at highly competitive rates. Our services include personal care and...
At Companion Care Partners LLC we identify with the many families that want to keep their love ones at home, without loosing sight that it is difficult to care for someone 24 hours a day. If your family would not settle...
Comfort Keepers of Philadelphia, PA is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Visiting Nurse Group is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At AHC, we are dedicated to serving our communities most vulnerable citizens and Insuring that all their health care needs are met carefully. Our mission is to enhance the quality of life of our Patients by providing...
Credence Home Care Agency, Inc is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our commitment to caregiver education clearly separates us from the others! About Us Keystone Home Care was founded in 2014 by Cherie Walker. Cherie always had a natural knack for caring for others. After caring...
VNA of Greater Philadelphia is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bayada Nurses Philadelphia is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aanu Home Care is the provider of choice for the personal care of yourself and your loved ones. We provide in-home assistance to people who are injured, senior citizens or any adult who needs a helping hand with personal...
Our home is where we feel safe and comfortable the most. And living with a companion makes all things easier and better. If you need a partner in your daily life, turn to Pure Hearts & Helping Hands Home Care Agency. We...
Holy Redeemer Home Care-PA is a home care provider that services in Philadelphia, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SYNERGY HomeCare, the most trusted name in non-medical home care, is helping people have a safe home life with comfort, independence and dignity – one family at a time. We believe our clients and their families deserve...
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance the quality...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
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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.