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:
Senior Helpers of North Houston advocates for high-quality senior care. We deliver customized, dependable, and affordable care to help provide a high quality life for our clients and their families.
Angels Over Us is owned and operated by Lani Cabral, an experienced Senior Care Nurse Specialist. Lani used her experience and expertise to build a seasoned team of home care professionals to deliver a broad range of...
Stephen’s Provider Services, LLC provides dependable non-medical in-home care to individuals and families throughout Fort Bend County, Texas. We are committed to delivering high-quality, compassionate support that helps...
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 Sugar Land / Katy, TX area, please...
At Griswold Home Care for Richmond & Rosenberg, serving the Fort Bend County area, we offer compassionate in-home care for those who want support to live where they love. We are an award-winning pioneer in the non-medical...
Seeking compassionate and professional in-home care for one of your loved ones can be a stressful, time-consuming process. You always want to make sure you’re making the right choice when it comes to who will be taking...
At Home Matters, we’ve made it our mission to provide high quality care for seniors that allow our clients to remain safe, comfortable, and independent at home. Our approach is unique, based on years of research in the...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Always Family Home Care of Katy provides compassionate, personalized in-home care that helps older adults live safely and independently in the comfort of their own homes. From personal care and companionship to...
Your care needs deserve the best. Brookdale at Home is an in-home services agency with decades of experience providing care at home that’s designed to help you retain your independence longer.
CareCo offers a variety of services to meet each individual client where they need care the most. Our services are designed to supplement family support and medical care, providing comprehensive care coverage to our clients.
We are a senior home care service that allows your loved ones to stay where they feel most comfortable in Katy, Houston, and surrounding areas. Our trusted Katy staff can’t wait to meet your loved one. We want to know...
Prestige Nursing Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Adbright Healthcare Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Paix Health Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Trans American Healthcare Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Firststep Healthcare Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gilgal Healthcare Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Encompass Home Health Of Houston is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Relief Healthcare Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
JD Homecare Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
GRACE HOME HEALTH CARE AGENCY is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Priceless Home Health is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
St Patrick Home Health Services is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Excellent Home Health Care LLC of TX is a home care provider that services Richmond, TX 77406. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal...
Coastal Health Care Systems, Inc. provides the best care for you and your loved ones in the comfort of your own homes. We prioritize your safety and comfort.
Transcare is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bethel America Health Care Llc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Johad Healthcare Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Joystar Home Health Services Llc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Blessed Hearts Senior Care, LLC is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Reez Home Health Services is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At FirstLight Home Care, we provide peace of mind when caring for you and your loved one. If you or a loved one needs a little help at your home in Sugar Land, Richmond, or surrounding communities, with elderly care,...
Crescent Health Care Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
IN Touch Healthcare Services is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Lifetouch Health Care Services is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Evening Star Healthcare Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Madonna Healthcare Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Obycris Healthcare Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kristel Healthcare Services is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Benevolent Care Health Services Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ameuro Home Health Inc is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Parkway Healthcare Services is a home care provider that services in Richmond, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Synergy HomeCare of Katy provides certified caregivers and personalized care for seniors living with cognitive or physical limitations. We are an affordable, compassionate and respected home care choice for families who...
Sweet In-Home Care is a locally operated small female owned non-medical in-home private duty care service with specialized personal care plans for seniors, expectant/new mom(s), disabled, and anyone in in recuperative or...
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
At Good Faith Seniors Homecare, Inc., you will receive the care that you deserve to have. Good Faith Seniors Homecare, Inc. provides the optimum level of health and comfort. Whenever life’s difficulties hinder you from...
Feel better in the comfort of your own home. We specialize in care and daily living assistance to an array of individuals of all ages. Whether you need daily care, night care or weekly assistance due to aging, illness,...
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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.