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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:
At Amada Eastern North Carolina, we provide non-medical in-home care for seniors. We know how important it is for our clients to continue to do the things they love at home, so we help make life easier and more enjoyable.
At Home Eldercare is the perfect solution for seniors who wish to remain independent in their own homes, but may need assistance because of the normal occurrences of aging such as reduced eyesight, arthritis, and...
Stay at Home Senior Care and our legacy Family of Providers have had the privilege of serving families and seniors for over twenty years. We have built a network of extraordinary homecare provider agencies that...
The Senior Care market is a rapidly expanding industry that continues to be competitive. We differentiate ourselves every day with the quality of our senior care services, how we speak and how we present ourselves. Our...
Options For Senior America - Cary is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Eagle Healthcare Services, Inc, located in Raleigh, NC, provides comprehensive healthcare services designed to meet the diverse needs of individuals in the community. Their services include personalized care solutions...
A1-Omega Health Services is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
QUALITY SENIOR CARE AT HOME The Senior Care market is a rapidly expanding industry that continues to be competitive. We differentiate ourselves every day with the quality of our senior care services, how we speak and how...
Choosing the right in-home care team can be a daunting task. It’s important to make sure your caregiver is qualified, skilled, and trustworthy. This is why ComForCare offers the best Raleigh senior care in town. We...
As we age or face an injury, disability, or chronic condition, simple responsibilities around the home and taking care of our physical health can sometimes become too much to handle alone. However, with the right support,...
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...
Licensed for Hands on Care and Companion Services Fully Insured Licensed by the Department of Health and Human Services Division of Health Services Regulation Covering 14 counties out the Raleigh office: Wake, Alamance,...
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...
Justheo Home Care LLC** is a home care provider in Raleigh, NC, offering personalized in-home care services for seniors and individuals with disabilities. Their trained caregivers assist with daily living activities to...
Caring Hands Health Services, Inc is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Broadway Home care, located in the scenic areas of North Carolina, we offer excellent home care services to our patients and clients. Our staff members and caregivers provide the highest level of professionalism in...
Angels that care and where love and healing is brought to your home. As dedicated care professionals we restore balance, order, and peace to your lives, by helping your love ones remain safe at home. We've been...
Gentiva Health Services is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Above The Horizon Home Care LLC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Omega Healthcare Services, LLC provides care for all age groups to include the elderly, adult and children in and around Wake, Johnston, Franklin, Durham, Person, and Orange, Vance, Granville, Chatham and Harnett counties...
Home Care Services provides innovative solutions that improve health and quality of life for those in need of our services. We deliver care according to your plan of treatment to maximize independence while you remain...
Offering a wide range of services that are delivered by highly skilled professionals who are committed to meeting the emotional and physical requirements of clients and their families.
Are You Looking for Peace of Mind Homecare Services for You and/or Your Loved One? Then you look no further!!!ACCESS HOME HEALTHCARE INC (AHHC) is here for you! AHHC Inc. is a Home Care Agency incorporated in the state...
Americare Alliance of Wake County is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A1-Omega Healthcare Services Inc is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Senior Service is a trusted homecare choice for seniors and their families in the area. Read more about our homecare services for this area. Caring Senior Service offers services, education and safety care...
Ally Health Services, LLC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AccordCare - Raleigh, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
BrightStar Care offers a wide variety of high-quality services—from in-home care to medical staffing. If you are looking for a trustworthy care provider or staffing partner in the Midtown Raleigh / Durham, NC area, please...
At Home Eldercare of E Wake County is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Who We Are We are a Veteran-Nurse owned agency that desires to recreate the views of agency nursing as a whole. Our goal is to be more than just the name you see on that invoice. Ensuring to provide the Best there is to...
First Choice Home Health Inc is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Carolina Homecare Solution, Inc. is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Absolute Care Staffing Health Agency, Inc. is independently owned and operated. It was founded because we saw the need to provide compassionate and caring professionals to treat home care clients with the care, the...
Comfort Keepers of Raleigh, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
aring For You Services LLC is a premier non-medical home care agency based in Raleigh, North Carolina. Dedicated to enhancing the quality of life for seniors and individuals with disabilities, we offer compassionate and...
At Home Quality Care Inc is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All Time Health Care Inc. is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care by Your Side & Services, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All Life Home Care's goal is to provide professional, compassionate care to individuals. While Maintining their independence and quality of life in their home or community.
A and M Home Care is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cottage Home Health Care is a licensed home health care agency that offers quality services to seniors and persons with disabilities in need of personal assistance. Our certified nursing assistants provide personal aid...
Blue Cross Home Health is dedicated to providing exceptional and compassionate home health care services tailored to meet the unique needs of our clients. Our mission is to enhance the well-being and quality of life of...
Accessible Home Health Care of Mid Carolina creates a high-quality, safe environment for your loved ones, allowing them to stay in their own home and receive the care they need. Accessible Home Health Care is the...
Classic Home Healthcare and Counseling Services is driven by the philosophy of commitment to our patients, leadership and excellence. We recognize the unique physical, emotional and spiritual needs of each person. Our...
Our Services -Companion Care For our basic level of care, caregivers provide services such as companionship, meal planning and preparation, light housekeeping, laundry, medication reminders, and other general assistance....
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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.