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.
✔
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:
Our Manchester, CT home health care provides safe and joy-filled homes for seniors! Seniors enjoy memorable days full of fun activities with our happy caregivers We believe joy accelerates healing. So, whether we’re...
A & B Homecare Solutions - New Haven is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Prestige Companion & Homemakers, LLC is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care For Me At Home was started out of personal experience and we continue the “personal” in everything we do. We are large enough to meet a diverse range of client needs and small enough to know each of our clients...
We are committed to improving the quality of life for our clients at Tender Hands. Our aim is to provide our clients with an atmosphere of love and care that enables them to feel independent. We’re providing our clients...
At Secure Hands Solutions, we understand aging is a natural process. We can help alleviate the stress and potential risk of running errands and maintaining your home. We offer cost-effective care and flexible schedules.
There’s a reason why Unity Home Care LLC, is a leading provider of homecare in Farmington, Connecticut, and that’s simply because we truly care for you! Elderly, injured, ill, and the disabled—we make every high-quality...
Aiming Higher is dedicated to providing in home care that will allow you to age gracefully at home with dignity and pride. See how we can make independent living easier for you.
Angelic Visitation LLC is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Dynamic Hands Home Care, LLC, your trusted partner in personalized and compassionate home care services in Manchester. With over two decades of expertise in the home health care industry, our agency is...
All Ways There Home Care LLC is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OOB Seniors Helping Seniors - Manchester, CT is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sacred Touch Homecare offers a range of non-medical homecare services 24/7/365. Our clients are seniors, new parents, individuals transitioning from the hospital, rehabilitation centers and individuals who need...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Seniors Deserve a quality life! and families deserve peace of mind! its time for.. Meet stay@home care .We are a home-care agency with experience since 1996 serving many seniors and their families.We believe in...
Divine Touch Home Care of Manchester, CT is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Divine Touch Home Care is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Peaceful Angels Homecare is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mercy Home Health Inc. is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Purple Hearts Home Care is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Careplus Home Care, we provide reliable and affordable home care services. As your trusted home care service provider our staff guarantees personalized attention to all of your home care and related needs. We care...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Manchester, CT. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Non-Medical in Residence Companion and Home Care. From a few hours a week to 24/7 care, we'll tailor a home care plan to fit your lifestyle with the flexibility to change as your needs change. Our services include...
Compare Home Care Agency Costs & Services
×
Success!
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.