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.
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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:
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...
The Mission of the Health Angels Home Health Services LLC is to enable patients under our care to live independently and retain a sense of freedom of choice as they age. Our specialists work closely with the patient,...
Our home care agency provides essential in-home support services to seniors and individuals with disabilities, helping them maintain independence and quality of life. We offer assistance with daily activities such as...
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 Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
H&T Beyond LLC is a trusted home care provider in Sharon Hill, PA, offering non-medical support services to seniors and individuals with disabilities. The company is committed to enhancing the quality of life for its...
BFRIN Home Care is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Rabbi Home Care, Inc is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Hand Home Care, LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Greater Love Home Care of Upper Darby, PA is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to provide quality services to our clients so that they can be safe and healthy at home with their loved ones. Whether you want to be part of our agency as clients or caregivers, we promise to treat you...
Complete Healthcare Services Inc is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARE FIRST NURSING, INC. is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Care and Staffing Services, Inc. of Upper Darby, PA is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Passion Home Health Care is a home health care agency in Upper Darby, Philadelphia. We are licensed to provide home care services in Philadelphia County, Delaware County, Montgomery County, Chester County, and Bucks...
Udy Home Care Services LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Who We Are Non Medical Home Care Experts Here to Serve You AD Homecare is the most Reliable, Trustworthy Home Care Agency Service in Philadelphia Area — providing excellent home care solutions to seniors and...
Magenta home care services, inc. is committed to providing high quality, Client centered and affordable home care services to our clients to assist them to lead dignified and independent lives in comfort and safety of...
We are committed to improve the quality of life of each patient by delivering ultimate health care and support services geared toward an individual care facility focusing on mind, body, and soul.
AD Homecare Services, LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to provide support and excellent care to seniors who face various challenges of aging, and to children who wish to improve their overall quality of life. Through carefully-designed services, our team of...
Caring Together Companion, LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Continuous Home Care Inc is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ASA Homecare Inc is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a trusted home care agency in Upper Darby, Pennsylvania. We are a privately owned and operated provider, serving the counties of Montgomery, Philadelphia, Bucks, Chester, and Delaware. Our home care services cater...
Preferred Care at Home of Upper Darby, PA is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mission Statement Delight Human Services LLC is committed to providing an ethical living environment for their staff, individuals, and their loved ones. As the saying goes “love is life”, we are committed in providing...
Nation wide home care services is a name families can trust to provide the best home care for their loved ones. We have been a leading elder care provider since 1998. Our professional and dedicated caregivers proudly help...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
Modern Health Home Care is a premier home care agency established to provide the Highest Quality Care to our clients. Our staff shares a deep-rooted commitment to compassionate and attentive care. We take great pride and...
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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.