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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.
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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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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...
Warm Angels Home Care Agency is a home care provider that services Allegheny county, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care...
Once you have determined that your elderly loved one needs assistance, it is important to honor their wish to remain happy and independent in their own home. But for your own peace of mind, you need to know that they are...
A Caring Hand Home Care, Inc. does not discriminate against any person on the basis of race, color, religion, disability, or age in admission, participation, or receipt of the services & benefits under any of its...
Home Helpers® Home Care is a in-home care service that provides top quality in-home care. Our Cared-4℠ program is a holistic approach to meet the four primary areas of need, helping your loved one stay safe and...
An Amazing Personal Care Corp. is a provider of home care in Pittsburgh, Pennsylvania, devoted to furnishing amazing solutions that meet the unique demands of ever-changing home care needs. Every caregiver in our team is...
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...
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...
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...
Trusted Senior Home Care in West Pittsburgh, Pennsylvania Whether a family member needs a little extra help around the house, assistance recovering from a hospital stay or someone to check in on them throughout the week,...
Quality Care 4 All LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Grandma's Helping Hands, LLC is dedicated to providing compassionate and reliable home care services to seniors and individuals in need throughout the Pittsburgh community.
Paramount Home Health Services is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A CARING HEART HOME HEALTH CARE, LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
United Hands Home Care Agency LLC, PA is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Steel City Champion Home Care LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A SUN STARR INDEPENDENT LIVING is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ONE FAMILY HOME CARE INC. of PA is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Candid Homecare of Pittsburgh, PA is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
MAHONE IN-HOME HEALTH CARE, LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gated Hearts is an equal opportunity employer and service provider. Gated Hearts , provide all services and referrals relative to patient care and employment actions to any eligible and qualified individual regardless of...
The Exurbia Group of Pittsburgh, PA is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allegheny Home Care of Pittsburgh, PA is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angels Of Care By TLM LLC is a licensed insured and bonded Home Care agency based in Pennsylvania. We provide 24-hour care including live-in services, that provides one day service up to 24 hours a day, short-term and...
HEALING HANDS & HEALING HEARTS LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
THE BLESSING HOME CARE, LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Oakdale or in surrounding areas like Bloomfield, or North Shore. Our trusted Pittsburgh staff...
ANOVA HEALTH CARE SERVICES INC of Pittsburgh, PA is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
NEW GENESIS HOME CARE LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Golden Care Homecare LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DYWAYNE'S GENTLE HANDS HOMECARE is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ALWAYS AT HOME CARE LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Humane Succour Home Health Services, we are dedicated to providing compassionate, high-quality in-home care tailored to meet the unique needs of each individual. Our mission is to enhance the quality of life for our...
Care Solutions in Pittsburgh, PA is a provider of various healthcare services, focusing on delivering personalized care solutions to meet the needs of individuals and families in the area. They offer a range of services...
Loving Hearts & Hands Health Agency, LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
LOVED ONES HOME CARE AGENCY, LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Trotman Home Health Care Services is dedicated to providing high-quality, personalized care to individuals in the comfort of their own homes. With a team of skilled and compassionate professionals, we strive to enhance...
Acti-Kare is a leading in-home senior care company that has been trusted for over a decade. Our caregivers are insured, bonded, and trained which means you will receive a trusted and professional caregiver every time....
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...
Connecting Family Legacy believes that the client is the most important person. We recognize the individuality of each of our clients. Connecting Family Legacy wants our clients to feel great in the comfort of their own...
Jeff Kosor opened the Senior Helpers of Southwest Pittsburgh office to provide dependable, affordable in-home care to seniors throughout Southwest Pittsburgh community. Senior helpers creates a comprehensive at-home plan...
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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.