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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:
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...
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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...
At Happier Home Care, we take the time to discover what makes each of our clients happy; then we incorporate those special activities into the care we provide. We are passionate about bringing happiness back into our...
It doesn’t matter if you’re here because you’re looking for help living independently, or if you want to make sure someone you love has the support they need to stay in their home. We believe there’s more to caring for...
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We specialize in providing value-based, comprehensive care and coverage for older adults with significant needs so they can thrive in the homes they love and in the communities they cherish. Our high-touch, team-based...
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WHO WE ARE Local Home Care Experts Here to Serve You Beyond Home Care is the most reliable and trustworthy non-medical home care service in the Los Angeles area providing excellent services for the elderly,...
Sunset Healthcare Inc. is a company that specializes in providing a wide range of healthcare products and services, with a focus on respiratory and home medical equipment.
At Senior Helpers we are here to help anyone we can. No matter how big or how small the task-- our goal is to keep your loved ones safe, maintaining or enhancing their quality of life.
Interim HealthCare of Pasadena, CA is a home care provider that services in Pasadena, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Pallas Care provides tailored in-home care services that help our clients maintain their independence and age with dignity. We believe that everyone deserves to be treated with respect, sensitivity, and to feel safe...
24 Hour Home Care - Pasadena is a home care provider that services in Pasadena, CA. 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...
TheKey Corporate - Central LA, CA is a home care provider that services in Pasadena, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TCC Home Care is a trusted provider of home care in Pasadena, CA. Our caregivers are well-trained, highly qualified, and carefully selected individuals who are thoroughly screened, and insured. Most importantly, our...
A Caring Place was started to help people with the best quality care in their home versus in a nursing home. In this way, we offer dedicated one-on-one care of your loved ones. This means more time and energy can be put...
When choosing Homewatch CareGivers, take to heart that extensively trained and compassionate employees strive to preserve dignity while enriching quality of life and empowering independence as much as possible.
Absolute Home Care is a home care provider that services in Pasadena, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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,...
VNA of Greater Los Angeles, Inc is a home care provider that services in Pasadena, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ComForCare Home Care - Pasadena, CA is a home care provider that services in Pasadena, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Virginia Home Care Agency is a home care provider that services in Pasadena, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Select Home Care in Pasadena is the premier choice for Pasadena home care and people struggling with illness, disability, or the changes that often accompany aging. We provide comfortable and professional care for...
SYNERGY HomeCare of Pasadena, CA is a home care provider that services in Pasadena, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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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...
Accredited Home Health Services is a home care provider that services in Pasadena, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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BrightStar Care was established with the senior in mind. We are dedicated to providing quality care and companionship. We offer a FREE in-home assessment to determine what services are best suited to your individual...
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...
Vital Home Health Care is a home care provider that services in Pasadena, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In memory of our mom, Livewell Private Care continues to provide the loving, professional and tender care that families have come to expect from our Livewell brand. Our focus is on hiring and placing the most qualified...
As "baby boomers" began to officially turn the population tide on January 1, 2012, the increased need for senior in home care became a national discussion. In the past, families were faced with few choices when their...
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...
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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.