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:
In-Home Care Overview: Senior Helpers – Costa Mesa, Newport, Fountain Valley, Santa Ana, Orange CA At Senior Helpers, we are here to help anyway we can -- no matter how big or how small the task.
Acti-Kare of Tustin, CA provides tier one in-home Personal care. Our trained, insured, and bonded caregivers will provide your loved one with in-home personal care services across a broad range of categories. As we age,...
Assistance In Home Care began with a vision by the owner, Ramona Streit. 17 years ago, her brother was suffering with cancer and he required in home care. Over time, the family realized the services that were received by...
Home Helpers Home Care of Orange Coast is more than an in-home health care agency – we’re your extended family when family can’t be there. We’re a locally owned, trusted provider of quality, compassionate in-home care in...
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...
Homewatch CareGivers of Yorba Linda, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
If you are currently caring for a loved one that is having challenges living independently, we understand how difficult it can be. With the right kind of help, it’s possible to improve their quality of life so they can...
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...
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...
Home Matters Caregiving of Orange County is an in-home care provider that services Huntington Beach, Seal Beach & Surrounding Areas. Our home care services allow seniors & other adults in need to remain safely in their...
What sets us apart from other companies is our specialization in live-in care. Unlike higher-cost agencies that primarily offer hourly services, we focus on providing continuous, dedicated support that enhances the...
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
At Home Helpers® Home Care we offer personal care & companionship care. We assist with elderly care and the basic activities of daily living like hygiene, cooking, mobility, errands and light housekeeping to help your...
Stat Home Care serves clients in Southern California with quality home care services. Our primary purpose is to make life easier for individuals who are in need of constant supervision and assistance. With our services,...
Arosa - Orange County is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cerna HomeCare - LA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We know how much your loved one means to you and we have set out to simplify the non-medical senior care process. Our company was founded on the belief that quality care can be easy and stress free. We believe that all...
American Homecare, Inc provides premier care for seniors in the comfort and familiarity of their own homes. American Homecare caregivers provide assistance with daily activities of living such as bathing, cooking,...
4EVER YOUNG LIVING LLC is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Care Placement is a local, privately owned in-home care, placement, and care management agency. Our mission is to provide a compassionate, world-class customer service experience to our patients and clients. Our...
ElderCare Anywhere is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Live life your way in the comfort of home with Home Helpers Home Care of Orange Coast! From a few hours a week to 24/7 care, we’ll tailor a personalized home care plan to fit your lifestyle with the flexibility to change...
AllCare Homecare provides compassionate and personalized in-home care services to seniors and individuals requiring supported living services. We prioritize our clients' independence and dignity, and our goal is to help...
Cerna Homecare - Irvine is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are here to support you with compassionate home care services. Our team offers a complimentary assessment to create a personalized care plan, helping you remain safely in the comfort of your home with the assistance of...
At Lynda's Home Healthcare, we began with a simple idea: to deliver reliable and compassionate in-home care services to those in need. Over the years, we have evolved into a trusted provider of quality personal care...
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...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Ativa Home Care - Newport Beach is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARE NOW HOME CARE SERVICES LLC is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Arosa, we believe in keeping the entire trust circle actively involved in care plan development so we can all make informed choices that are truly in the client’s best interests. Contact us today to learn more about...
Oso Home Care, Inc is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
KIND CARE is an In-Home service provider, which assists individuals to lead dignified and independent lifestyles in the comfort and safety of their own homes. We are a business designed to provide a unique all-in-one...
At Home Personal Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comfort Keepers of Irvine, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elite Health Group offers the ideal home care solutions for Orange County residents who want to maintain their independence and dignity by continuing to live in the comfort of their own homes. Let our highly experienced...
After serving in home care for years, Ronel & Rozen Ocampo felt they could offer their BEST CARE for families if they were in charge of their own Caregiver staff and were "hands-on" in their dedication to their family...
CERNA HOME CARE is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors R Special is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Caring Ember, we provide licensed and certified non‑medical home care throughout Orange County, Los Angeles, and surrounding areas. We take great care in in matching each client with trained, certified, and...
Ativa Home Care - Newport Beach is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ActiKare of Irvine, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
President and CEO of Interim HealthCare of Irvine, Khushbu Dadlani, has spent the past 10 years caring for and educating preschool children. Faced with the challenges of caring for her own parents-in-law, Khushbu’s...
LivHOME Orange County is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When you or your loved one need help at home, turn to FirstLight Home Care of Irvine. We offer complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just...
As a family owned, not for profit organization, Canaan Home Care is at the forefront of the home care industry. Canaan has been a partner of the State of California for over 25 years, together, raising the home care...
Acti- Kare of Irvine provides senior care and home care services in the following locations including Irvine, Newport Beach, University Park, and Northwood in California.
At Golden Years Home Care Solutions Inc – San Diego, our mission is to provide compassionate, personalized, and dependable home care services that empower seniors and individuals with disabilities to live safely,...
At Senior Helpers, we are here to help anyway we can -- no matter how big or how small the task. Our owners, Sandy and Hector Muñoz, know personally what it's like for the people in need of care and the toll it takes...
Golden Age Companions is dedicated to improving the lives of seniors and others who have reached the point in life where they need companion care. We’re dedicated to providing personable, hands-on, and integrated caring...
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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.