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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.
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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:
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...
Welcome to SYNERGY HomeCare of Suwanee. Up to 24-hour home care. CARE THAT MOVES YOU. Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with...
With highly personalized care and a dedicated team of compassionate caregivers, you and your family can expect more from HomeWell Care Services in Lawrenceville, Gwinnett County and surrounding areas.
For over a decade Acti-Kare Responsive In-Home Care has provided premier in-home Personal Care to individuals across the United States. Our trained, insured, and bonded caregivers will provide in-home Personal Care...
At A Gentle Touch Home Care, our mission is to provide compassionate and personalized support that enhances the quality of life for individuals needing home-based care...
We provide both medical and non-medical service so we can adapt to your changing needs. We strive to have the most competitive rates in the region. If you are already receiving private duty home care, please contact us...
A L Gordon Care Group Inc is a home care provider located in Roswell, GA 30076, offering services designed to help seniors remain safely in their own homes while receiving necessary medical or personal care.
Our team of experienced healthcare professionals, including registered nurses, social workers, and certified nursing assistants, is available 24/7 to support you and your loved ones. We believe that access to quality...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
When life's events- aging, illness, or disability make living at home more difficult Assisting Hands Home Care understands. Our dependable caregivers offer the very finest personalized non-medical care including...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Palrine Home Care is a trusted provider of personalized in-home care services, committed to helping individuals maintain their independence and quality of life in the comfort of their own homes. With a team of...
Serenity Care and Compassion is Locally Operated, Licensed, Bonded, Insured, and have been providing compassionate care in Georgia For 15+ Years and are happy to provide services to older adults and children in need of...
Charlotte Web Private Home Care, LLC is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Bisol Homecare Services offers personalized and compassionate in-home care for seniors and individuals with disabilities. Our skilled caregivers provide assistance with daily activities, medical care, and warm...
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...
Welcome to CarePurpose CarePurpose offers a wide range of health care services from companion sitter care to skilled nursing assistance for families needing in home, hospital or nursing facility care. With the rising...
At Nathan Home Care and Nursing Agency LLC, our vision is to be the premier home care provider in Georgia, recognized for our unwavering commitment to excellence, innovation, and compassion. We envision a future where...
Direct Healthcare Services is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Destiny Home Care of Georgia is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Embracing Hearts at Home, LLC is currently serving Gwinnett, Clayton, Barrow, Hall, Fulton, Cobb, Jackson, DeKalb, and Forsyth counties. We provide nurturing care and support to those who wish to stay in their own homes...
Synergy HomeCare of Suwanee, GA is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our company provides quality in home care to elderly, disabled and post operative patients. We pride ourselves in going the extra mile for our patients. We are Georgia state licensed in both home companion/sitter and...
Seniors Helping Seniors - Metro Atlanta, GA is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Atlanta Blessed House Caregiver is on a mission to empower our clients to have total confidence in our ability to deliver exceptional home care services consistently.
Lois Comfort Homecare of Suwanee, GA is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
For over 30 years, Griswold Home Care has been referring the best Caregivers. We only refer Professional Caregivers that pass our stringent “CareAssure Screening System”. For your peace of mind, all of our Caregivers have...
At CareMed Private Homecare Solution, we provide reliable and affordable home care services to clients in the Atlanta Georgia Metro area. Whether you need daily or weekly assistance due to aging, illness, recovery, or...
CAREMED PRIVATE HOMECARE SOLUTION, LLC is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Oma Business Corporation is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HOMELOGIC HEALTHCARE LLC is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Its Home LLC is a trusted home care agency based in Atlanta, Georgia, providing personalized and compassionate care services to individuals in the comfort of their own homes.
iProvide Home Care Solutions - Suwanee, GA is a home care provider that services in Suwanee, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Regency Home Care of North Atlanta, there is no higher priority than the health and safety of our clients. When a loved one requires extra care and assistance, turn to Regency’s certified expert care staff, because...
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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.