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.
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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:
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Through personal care plans with Comforcare Home Care services, our office can determine the best plan of individual care based on your families specific needs. Our dedicated caregivers can be available for as little as a...
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...
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,...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Home Matters of Philadelphia-- Montgomery County is a home care provider that services in Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
HomeWell Care Services of Norristown, PA is a home care provider that services in Lansdale, 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...
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...
Serving Lansdale and the surrounding areas, Senior Helpers Harleysville and their team of exceptional care providers provides the highest level of in-home care to seniors and their families. Knowing your loved one is...
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,...
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.
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...
“Combining Quality, Compassion and Care” Thank you for your interest in Synergy HomeCare of Montgomery & Bucks Counties. Whether you need only a few hours a week or 24/7 live-in care, we can do it. With competitive rates,...
Devinecare Health Services (DHS) is family-owned home care and staffing agency located at Lansdale, PA. Since 2020, We have recruited a good numbers of healthcare workers for nursing homes and medical institutions in...
Home Helpers Home Care of Lansdale, PA is a home care provider that services in Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home - Lansdale, PA is a home care provider that services in Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Option Companion Care DUPE is a home care provider that services in Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
You Have Options! All our caregivers go through health screenings, competency tests, reference checks, child abuse checks, and background checks, TB test and all our caregivers are compassionate, driven, and...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
HELPING HANDS AT HOME HEALTH CARE LLC is a home care provider that services in Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BUX-MONT HOME CARE is a home care provider that services in Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carvell Homecare Inc is a home care provider that services in Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
North Penn VNA is a home care provider that services in Lansdale, 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 Lansdale, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Homewatch CareGivers of Central Bucks County, PA is a home care provider that services Warminster and the surrounding areas in PA. Home care services allow seniors to remain safely in their home, senior community or...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
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.