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:
When it comes to choosing an in-home senior care provider in Prosper, we know that you have many choices. CareBuilders at Home’s commitment to client engagement and safety, innovation, and quality services sets us head...
Adage Home Care provides compassionate, dependable in-home assistance that supports comfort, safety, and independence. Caregivers offer personalized daily care and meaningful companionship—giving families confidence and...
Our home care services can help aging adults stay engaged in everyday life with tailor-made support by professional caregivers to stay safe and well at home. It’s our mission to provide a care plan personalized to your...
Home care enables you or your loved one to continue living in the comfort of home with assistance from a qualified home care provider. We respect the many factors and careful thought that go into making decisions for the...
Right at Home Lewisville believes there is far more to caring for people than simply providing in-home assistance. You deserve a care partner who understands the journey ahead and will help you navigate every step....
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
One You Love Homecare provides senior in-home care services for your loved one. We pride ourselves on being one of the only homecare organizations that delivers what we like to call, “Always Caring Expertise.” Simply put,...
At A Better Solution In Home Care, we believe that aging, recovering, or living with a disability should never mean losing comfort, dignity, or independence. Founded with a deep commitment to compassionate service, we...
Our experienced and professional caregivers provide the care and support you or your loved one need to remain living independently at home while providing peace of mind to the family caregiver.
Herewith, Inc. is a nationwide platform connecting families with caregivers for in-home non-medical assistance. In Texas, they offer flexible senior care services through a network of "Caregivers" who assist with tasks...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Every day, we strive to live our mission of caring. This dedication is evident in the high-quality, individualized care we provide, the support and development opportunities we offer our caregivers, and the collaborative...
Our compassionate caregivers provide personalized in-home care services that support your loved one’s comfort, independence, and well-being – right where they feel most secure, in the place they call home.
At CHRISTY GRACE HEALTH CENTER INC, we focus on providing the highest standards of clinical care with compassion. We offer a variety of comprehensive healthcare services in the comfort of our clients’ homes. We provide...
FirstLight Home Care of Flower Mound provides personalized in-home care services to seniors, veterans, individuals with disabilities and adults recovering from illness or injury in Flower Mound, Lewisville, Carrollton,...
Our in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing compassionate care in the...
Senior Care Transitions, LLC is a home care provider that services in The Colony, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alliance Homehealth Care is a home care provider that services in The Colony, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SHANTI HOME CARE TX LLC is a home care provider that services in The Colony, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ready HH Inc. is a home care provider that services in The Colony, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
V Care Home Health Inc is a home care provider that services in The Colony, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Care Companion is based in the Dallas Fort Worth Metroplex serving Dallas, Lewisville, Coppell, Frisco, Flower Mound, Carrollton, Farmers Branch, Addison, Richardson, Plano, Irving, Hurst, Euless, Bedford, Grand...
ADROIT HEALTHCARE SERVICES is a home care provider that services in The Colony, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Cloud9 Private Caregivers LLC, we believe that compassionate care begins at home. Our experienced caregivers provide personalized assistance with daily activities, companionship, and specialized support, ensuring each...
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 Always Best Care, we believe it’s a good feeling to be included in our clients' lives. Subtle smiles and long talks, showing kindness and humor during difficult times, providing the right levels of care – these are the...
Comfort Keepers is the leading provider of customized home care services for Carrollton, Coppell, Lewisville, Flower Mound, Farmers Branch, and Addison. Our independently owned and operated Carrollton office provides...
At Griswold Home Care of Plano, our mission is to provide outstanding home care services from outstanding caregivers. Griswold Home Care allows seniors to stay in the home that they love, while maintaining their...
Senior Helpers of Richardson offers companion care, personal care, and chronic disease care to seniors in the Greater Dallas area. We help you to decide what care service is best for your loved one and family 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.