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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:
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.
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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...
WelbeHealth is a Program of All-Inclusive Care for the Elderly (PACE), full-service healthcare provider that helps you live your life healthy and happy, in your own home.
Home Instead - Simi Valley, Ventura County, CA - Duplicate is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
The Amada Senior Care team in San Fernando Valley is dedicated to going beyond basic home-care by gaining a deep understanding of clients and their individual needs so that they can make a truly positive impact on their...
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...
We have a genuine concern for the health and well-being of others and an incredible opportunity to help people live their best lives. By focusing on relationships, we create caring environments where people are encouraged...
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...
As loved family members age, it can become increasingly difficult to provide them with the attention and care they require. Homewatch CareGivers of Northridge understands these challenges and has been providing...
Perfect Fit Home Care is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Preferred Care at Home of Thousand Oaks, you can expect high-quality and personalized care from our family and our caregivers. Our desire is to help you remain in the comfort and security of your home, or wherever you...
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...
Caress Home Health Providers, Inc is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angel Heart Home Health Care of Canoga Park, CA is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Valrose Home Health, Inc is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
EVOLVE HOME HEALTH is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are the "Accessible Health Care of LA Valleys" one of the premier, full services, multi-state home health care providers, with a local operation based in Canoga Park CA, and many others across the United States. We are...
Option One Home Care Inc is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Supreme Home Health Services, Inc is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hhc Health Care is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
WICARE LLC is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
THE WEST VALLEY IN-HOME CARE AGENCY- "PROVIDNG QUALITY CARE WITH COMPASSION IS WHAT WE DO BEST". WE PROVIDE PERSONAL, CARING AND EXPERIENCED PROFESSIONALS: CARE-GIVERS AND COMPANIONS. WE ALSO PROVIDE CERTIFIED NURSE...
Medi-kare 1, Inc. of CA is a home care provider that services in Canoga Park, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AdvantagePlusCaregivers.com is dedicated to providing compassionate personal care for all people in need to advance or maintain the quality of their lives. We strive to uphold the highest standards in every endeavor we...
DG Comfort Home Care of Canoga Park, CA is a home care provider that services Los Angeles and Ventura county. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Hand Homecare Provider, Inc., is a professional and non-medical agency that provides home care in Canoga Park, California, committed and dedicated to providing care that you can count on in the comfort of your own home....
At Senior Helpers Westlake Village, we believe that getting the best care for your loved one should not be complicated. We are fully committed to delivering affordable, high-quality in-home care to seniors in the Orange...
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...
EVA In-Home Care LLC is a family-owned business that aims to help the elderly, those with disabilities, those who have just undergone surgery, and everyone who needs extensive home care and support. We promote health...
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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.