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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:
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...
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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...
Senior Helpers of Costa Mesa is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Caring for an aging loved one can be a deeply personal and fulfilling experience. However, at-home elderly care also requires a surplus of time and energy. With tight, busy schedules, it’s no wonder that so many people...
Our core mission is to provide the best personal care to our clients. We focus exclusively on personal care, assisting our patients in facing their daily challenges and undertaking their tasks comfortably. We help people...
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...
Why Dedicated Care In-Home Services? Dedicated Care is passionate about providing dependable, high quality care to our clients. We are not a franchise. We are privately and locally owned. Our clients are not just...
Companion Home Health Agency is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SYNERGY HomeCare based in Orange, provides a wide range of non-medical care options. Companion care includes assistance with cooking, shopping, running errands, light housekeeping and other tasks that allow clients to...
Whether you’re a new mother, recovering from surgery, or just need an extra hand around the house with daily activities, you can count on FirstLight Home Care of Orange to deliver compassionate home care services. Our...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
Colonial Home Care provides non-medical in-home care services, assisting you or your loved one with things which might otherwise be performed independently or by family members. After completing a thorough, complimentary...
ASSURANCE HOME CARE SERVICES INC is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home - Orange, CA is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interim Healthcare is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SYNERGY HomeCare of Orange, CA is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Age Advantage is a non medical home care services agency; we provide companionship, light house keeping, meal preparation, medication reminders, grocery shopping and doctors appointments, physical therapy home exercises,...
OOB - ComForCare Home Care - NE Orange County, CA is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
H3Assist is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
At Gentle Breeze Home Care, we provide compassionate, personalized in-home care services designed to meet the specific needs of each client, we prioritize their welfare and comfort. Our commitment is to go above and...
We are a Consumer Directed Care Agency and with our highly trained caregivers you can assure visible improvements. We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties...
Cambrian Homecare is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
St. Joseph Health System Home Health Agency is a home care provider that services in Orange, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alta Home Care is dedicated to providing personalized care that enriches the lives of our clients and helps them maintain the highest level of independence. Every Personal Attendant is carefully screened, selected, and...
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...
Tremendous Care is a family and Hoag physician founded home care agency based in Orange County, CA. We are committed to delivering compassionate, specialized care that meets the unique needs of each individual we serve....
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
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...
The hardships of aging or living with a chronic illness can feel isolating. Homewatch CareGivers of Orange is here to provide you or your loved one with the caregiving services and companionship you deserve. We are...
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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.