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.*
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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:
Adored by Me Home Healthcare Agency believes that homecare should be offered and made available to everyone who is in need of medical attention. Getting access to homecare should not be limited to select individuals but...
Unity Love Home Healthcare LLC is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
UNIQUELY PREPARED TO DELIVER excellent home care Affinity HealthCare Solutions stands apart as a home care agency that is uniquely prepared to provide trustworthy personal assistance to individuals and families with a...
Since 2011 Senior Helpers of Chestnut Hill – Philadelphia is the premier provider of senior care, wherever your senior resides in Philadelphia, Montgomery and Delaware Counties. We provide a full range of senior home care...
Neighborly Home Care - Ardmore is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Different Care Home Care LLC is a home care company based in Philadelphia, PA, specializing in providing non-skilled in-home care services. Their offerings cater to individuals who need assistance with daily living...
Allegiant Home Healthcare is a family owned and operated non-medical home care company. We have a combined 35 years of experience in the home and health care industry. Our experience, expertise and loyalty to the...
We are a home care agency in Ardmore, PA that is dedicated to delivering exceptional quality care and making sure all of your loved one's safety and personal care needs are met. Clementine Home Care, LLC is not only...
Tata Homecare Services LLC is a home care provider serving Montgomery and Bucks County, offering a range of services that allow seniors to safely remain in their homes while receiving essential care.
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 of Philadelphia-- Montgomery County is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Frans Stay At Homecare LLC, we are dedicated to making a positive difference in the lives of those we serve. Let us be your partner in compassionate and professional home care.
Caring for older adults is our passion and specialty, serving older adults for over 20 years! NursePartners is founded, owned, and operated by Angela Geiger, Registered Nurse and Certified Dementia Practitioner. We...
Accessible Home Health Care is committed to providing the highest level of in-home care to improve the health, wellbeing, and comfort of families all over the country. Each Accessible Home Health Care location is...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The Right Touch, Inc. is an in-home care company dedicated to providing compassionate, personalized care to individuals in their own homes. Offering non-medical services such as assistance with daily activities,...
BrightStar Care of The Main Line - Wayne, PA is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HomeWell Care Services of Norristown, PA is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our founder Quiera Dover watched many patients, seniors, and clients with intellectual disabilities fight to gain independence and decline in their ability to do for themselves. Quiera found that most seniors want to be...
At Agape Home Care Solutions, INC., our mission is to deliver compassionate and high-quality home care services to the people of Pennsylvania, enhancing their well-being and dignity.
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
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,...
TheKey Corporate - Bala Cynwyd, PA is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
“The best way to find yourself is to lose yourself in the service of others” - Gandhi Friendship Health Care LLC is an accredited non-medical home care agency in Pennsylvania that provides excellent and top-quality...
MOG Home Health Care Services is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Homemaking & Companionship Services An In-Home Caregiver is the ideal solution for people who need ongoing assistance with activities of daily living while staying in the comfort of their own home. We fill in the...
Personal Touch HC of PA Bala is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Penn Care at Home is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Londyn Home Health Care is a dedicated and committed home care service that cares about you. We have an A+ Rating and we are constantly receiving excellent reviews from our clients and patients. It is our passion to...
COMFORT SPACE HOME CARE, LLC is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AURA HOME CARE is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Harmony's Healing Hand Caregivers LLC is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Atlantic Home Care, Inc is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Maxim Healthcare Services Inc is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
THE HELP YOU NEED HOME CARE, LLC is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Choosing Amor Home Health Care means choosing peace of mind. Our reliable and trustworthy caregivers provide round-the-clock support, allowing families to rest assured knowing their loved ones are in good hands.
Jacobs Angels Home Care LLC is a licensed and insured in-home care (non-medical) agency committed to providing the best and most loving care in the comfort of the place you call “home”. We exist to help enable elderly...
Affectionate Reliable Care combines strength and standards with accessibility and personal service. The local owner and operator of Affectionate Reliable Care is Michael Friedberg. Michael and his team have your loved...
BRIGHT SPOT HOME CARE, LLC is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With Open Arms Homecare is devoted to providing outstanding care to those in need of companionship and in home assistance. Our mission is to provide outstanding care through highly qualified professionals. Our ultimate...
Nurtured Nest LLC is a state-certified, licensed, and insured home care provider in Bala Cynwyd, PA. We established our company with the aim of improving the lives of our clients through our person-centered care services...
Karing Kompanions Home Health Services was created for the purpose of providing excellent in home services to clients of all age groups and disability levels.
STERNS ESTATE HOME CARE AGENCY of Bala Cynwyd, PA is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
At Angel's Health Service, we offer quality, honest service in the Montgomery, Delaware, Chester and Philadelphia counties. Whether you are seeking daily or appointment based care - Angels Health Service strives to meet...
Wissahickon Hospice is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SKR HOME & HEALTHCARE SOLUTIONS, LLC is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
365 Health Services, LLC is a home care provider that services in Bala Cynwyd, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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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.