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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:
Comfort Keepers of Montclair, NJ is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our goal is to promote independence for our clients by providing compassionate care in the comfort of their homes. patient Often individuals require assistance with one or more of their activities of daily living such...
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
Wayne and Tricia Sarrow started Senior Helpers of Madison in 2007 to deliver the best possible in-home care to seniors in Morris, Essex, and Union counties. Our proprietary training and education programs ensure your...
Katrix LLC is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Griswold is an award-winning pioneer in the home care industry, with over four decades of experience and a storied legacy of compassion and integrity. We believe Care Professionals are the foundation of our success, and...
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...
At Full Circle Health Services we believe that the journey into complete and effective home care begins with our focus and dedication to fulfilling each client’s individual needs. To provide the highest level of care we...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
Unique Home Care Services is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Outfront Home Care LLC is a state-certified home care agency in Union, New Jersey that serves various counties such as Somerset, Middlesex, Essex, Morris, Passaic, and Bergen. We only provide quality service to our...
Amorycare is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Brimar Services, where we are dedicated to providing compassionate and personalized care for you and your loved ones in the comfort of your own home. Our team of experienced and skilled healthcare professionals...
HomeWell is not your average home care agency. For us, it’s not simply about placing a caregiver in the home. We take a holistic approach to at-home care that focuses on both accomplishing the tasks of daily living and...
CareTen Inc. - Union, NJ is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gracious Home Health Services LLC is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amorycare is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Loving Care Agency, our highly qualified team of home health aides are committed to preserving each person’s right to benefit from the familiarity and emotional comfort of being at home. As a fully accredited and...
Amorycare is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amorycare is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amorycare is a home care provider that services in Union, NJ. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
WHOM WE ARE: Humane Concepts Healthcare is a member of the NJ Homecare Association. We tailor our services to the needs of our clients. These services can be purchased for as little as a few hours or as many as 24 hours a...
Unique Home Care Services (UHCS) provides special Care and Companionship for Senior Adults in the comfort and privacy of their own homes, including retirement communities. Unique Home Care Services Delivers...
S&S Home Health Care Inc provides exceptional in-home care services in a compassionate and supportive environment for improving the individual’s physical, emotional, and mental well-being.
Amorycare Homecare was created based on the idea that forming a family-like bond between caregiver and client is the key to providing New Jersey families with the highest quality home health care experience. Amorycare...
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...
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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.