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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:
For those who wish to age peacefully or recover in a comfortable and familiar environment, HomeWell Care Services is committed to bringing you the highest quality of non-medical care and everyday support wherever you call...
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,...
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...
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.
Neighborly Home Care - Ardmore is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our in-home care services brighten the lives of seniors, who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier through compassionate support,...
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,...
Essence Home Care, LLC is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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.
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...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BELL ELITE SENIOR SOLUTIONS is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TAKE MY HANDS LLC is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TruVine Homecare Services, Inc. is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TATA HEALTH LLC is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The Lady Of Fatima team has been in the home care industry since 1997 providing elder care at home to hundred of senior adults in Philadelphia and the surrounding counties of Delaware, Montgomery, Chester and Bucks in...
Who are we? Deematech Solutions Health Staffing Agency provides qualified professional services that meet the needs and desires of the large growing health industry in the State of Pennsylvania at an affordable cost. We...
Lucimac Home Care Agency, LLC of Lansdowne, PA is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Arum Homecare is a compassionate and reliable provider of in-home healthcare services, designed to support individuals who require assistance with daily activities or medical care in the comfort of their own homes.
Quokka Home Care Agency, LLC of Lansdown, PA is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Jorpat Nursing Services Inc is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Affectionate Home Health Care Services is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Jorpat Nursing Services is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Would your loved one prefer to remain in the comforts of home? Mom's Loving Care provides companion and personal care services to seniors, those recovering from surgery, new and expectant mothers, and the disabled in SE...
TO KEEP AND TO COMFORT HOME HEALTH CARE, LLC is a home care provider that services in Lansdowne, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Typical home care providers only offer the basics. At Healing Helpers Home Care, we understand that there’s more to life than meal preparations and medication reminders. That’s why we follow a holistic approach to improve...
SYNERGY HomeCare, the most trusted name in non-medical home care, is helping people have a safe home life with comfort, independence and dignity – one family at a time. We believe our clients and their families deserve...
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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.