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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.
✔
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:
Community Home Care offers services to seniors in Cincinnati, Kentucky, and Dayton to enable them to remain in the comfort of a familiar environment. CHC is dedicated to the core values of combining quality care,...
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Paul Tobillo, owner of Amada Senior Care Cincinnati, has made it his personal mission to help the seniors in our community live safer and more enjoyable lives. Says Paul, “To care and to receive care are the most...
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...
The Senior Helpers West Chester office was opened in 2018 to match the growing need for in-home senior care in the surrounding community. We offer a wide range of services from companion care to chronic disease care. We...
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...
Constant Seniors Care LLC, based in Cincinnati, OH, offers personalized non-medical home care services to seniors. Focused on promoting independence, safety, and comfort, they provide compassionate assistance with daily...
The challenges of having aging parents drew Chris Nieman to Senior Helpers as a life's work that he could be passionate about. His team is committed to delivering the best possible in-home care to seniors in the Northern...
WHITE'S SAFEKEEPING HOME HEALTH CARE LLC THE is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to serve every person who needs our healthcare services in the comfort of their homes. They need not go too far to acquire the quality of life they deserve, for we will deliver it to them based on their...
BLESSING HOME HEALTH CARE INC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Connection of Cincinnati is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Pinnacle Senior Care is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TRG Home Health Services LLC is a home care provider that services Cincinnati, OH 45239. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care...
Blessing Home Health Care, Inc. is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When you need quality care but want exceptional care, you can depend on Heaven Sent Care. We understand your concern and fear of finding good and kind people to stay with your family member while they are recovering from...
GRACEFUL GOLDEN YEARS HOME CARE AGENCY is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Billie's Angels Home Care LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Visiting Nurse Association, The is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Children's Hospital Home Health is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heritage Hearts Home Care provides compassionate, personalized support for seniors in the comfort of their own homes. Our experienced caregivers offer a range of services tailored to individual needs, promoting...
First Choice Home Health Ohio, Inc is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
American Mercy Home Care, LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Affordable Assisting Angels LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caregivers Health Network is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
United Home Care Services is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Dakota Care, where we provide a wide range of non-medical home care services in Hamilton County Ohio, from respite care to Alzheimer's care. Whether you have an aging loved one who could use some company, a...
Hearts Full Of Love Home Care LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Judson Home Care is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Personal Touch Home Care of Ohio is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cornerstone Caregiving offers senior home care that allows your loved ones to stay in the comfort of their own home! Our services include Greater Cincinnati area including: Hamilton, Butler, Warren and Clermont Counties....
A Loving Companion Home Care LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Chambers Quality Care 24/7 Home Health Care Agency LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Hands of Perfection In-Home Care LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We provide the highest quality home care services to people in need of assistance. Our dependable caregivers focus on personal care and support with activities of daily living, errands, light housekeeping, medication...
Unique Quality Care With Love, LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Village Caregiving of Cincinnati offers a subset of home health services known as home care or personal care. These services are intended to allow the elderly to live as comfortably as possible in their own homes through...
HEAVEN SERVE HOME CARE AGENCY is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Care Partners Of Cincinnati, Inc is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Deaconess Home Health Care is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heavenly Angels Home Care Services, LLC is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HomeWell Care Services of Cincinnati, OH is a home care provider that services in Cincinnati, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to improve the quality of life for individuals by offering a secure, supportive, and friendly setting. We advocate for our members and work towards diminishing the negative perceptions associated 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...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
Our “Care Mission” is to provide stable and dependable Care Visits to our Senior clients, wherever they may reside… in their own home, or at an Assisted Living community. For the Senior’s family, our staff RN care...
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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.