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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.*
✔
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:
Charlotte Web Private Home Care, LLC is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bisol Homecare Services offers personalized and compassionate in-home care for seniors and individuals with disabilities. Our skilled caregivers provide assistance with daily activities, medical care, and warm...
Welcome to SYNERGY HomeCare of Suwanee. Up to 24-hour home care. CARE THAT MOVES YOU. Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with...
Care at Home Solution Discover the Care at Home Solution advantage, where our local focus is our strength. We offer personalized, client-centered in-home services to ensure the safety and well-being of the elderly,...
With highly personalized care and a dedicated team of compassionate caregivers, you and your family can expect more from HomeWell Care Services in Lawrenceville, Gwinnett County and surrounding areas.
Serenity Care and Compassion is Locally Operated, Licensed, Bonded, Insured, and have been providing compassionate care in Georgia For 15+ Years and are happy to provide services to older adults and children in need of...
Home Instead Snellville offers individualized in-home senior care right in your neighborhood. Our trained, screened and bonded CAREGivers are serving Georgia communities with compassion and devotion.
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Senior Helpers of Lawrenceville, GA is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Palrine Home Care is a trusted provider of personalized in-home care services, committed to helping individuals maintain their independence and quality of life in the comfort of their own homes. With a team of...
At Prive Home Care Network LLC, we are dedicated to providing exceptional in-home care and reliable medical transportation services tailored to the unique needs of each individual. Our mission is to enhance the quality of...
We provide both medical and non-medical service so we can adapt to your changing needs. We strive to have the most competitive rates in the region. If you are already receiving private duty home care, please contact us...
Our caregivers assist with activities of daily living such as bathing, dressing, grooming, and medication reminders, promoting personal hygiene and overall wellness.
With Epic Family and Community Services, you can rest assured knowing that you or your loved one is in capable and caring hands. Whether you need short-term assistance during recovery or long-term support to age in place...
Sirleaf Homecare is a proud independently owned and operated non-medical homecare that offers home care services that are flexible and customized for your comfort, peace of mind and well-being. Sirleaf Homecare only hires...
Kindly Home Care, INC is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors Helping Seniors - Dacula, GA is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Hope Home Care LLC is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Lifecare provides compassionate guidance for elderly loved ones. As your trusted partner, we assist in finding the perfect senior living solution through A Place For Mom, ensuring comfort, safety, and happiness in...
Detoff Cares is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Hope Homecare LLC is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Friendnfamily Care GA LLC is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Trinity Family Services, we understand that home is where love resides, and our commitment is to create an environment where your family member feels loved, secure, and supported. We are dedicated to making a positive...
Salient Healthcare Services - Dacula, GA is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
US Home Care Agency is just the perfect fit for your needs. Our agency has an exemplary staff, and support team that provides a wealth of personalized in-home care services. We provide care at the comfort of your home...
DEL MAR HEALTHCARE, LLC is a home care provider that services in Dacula, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Its Home LLC is a trusted home care agency based in Atlanta, Georgia, providing personalized and compassionate care services to individuals in the comfort of their own homes.
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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.