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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 offers care services in Tustin, Costa Mesa, Irvine, Newport Beach, Santa Ana, Dana Point, Laguna Niguel, Laguna Woods, and the surrounding areas. Our goal is for seniors to live independently, healthily,...
Homewatch CareGivers of Yorba Linda, CA is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Acti-Kare of Tustin, CA provides tier one in-home Personal care. Our trained, insured, and bonded caregivers will provide your loved one with in-home personal care services across a broad range of categories. As we age,...
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...
Senior Helpers North-Central Orange County was founded in 2006 and purchased by owner Brian Nakamura in 2015. Brian and his staff are committed to enriching the lives of seniors in the Orange County area and providing...
Unlike in-home care franchises, Care for SoCal is owned and operated by two nurses-an RN and an LVN-with experience in multiple specialties of nursing and in-home care, for people of all ages and circumstances. Whether...
At Friends and Family Home Care, we understand the importance of comfort and familiarity. That's why we bring professional care right to your doorstep, ensuring your loved ones receive the support they deserve in the...
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...
Caring for an aging loved one can be a deeply personal and fulfilling experience. However, at-home elderly care also requires a surplus of time and energy. With tight, busy schedules, it’s no wonder that so many people...
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At Home Helpers® Home Care we offer personal care & companionship care. We assist with elderly care and the basic activities of daily living like hygiene, cooking, mobility, errands and light housekeeping to help your...
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Exceptional Care for Your Loved Ones Our mission is to provide exceptional support to your loved ones in their golden years or those facing well-being challenges. Bella Vie Homecare LLC delivers premier care services...
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SYNERGY HomeCare of Huntington Beach, CA is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Helpers Home Care of Orange Coast is more than an in-home health care agency – we’re your extended family when family can’t be there. We’re a locally owned, trusted provider of quality, compassionate in-home care in...
Home Matters Caregiving of Orange County is an in-home care provider that services Huntington Beach, Seal Beach & Surrounding Areas. Our home care services allow seniors & other adults in need to remain safely in their...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
When you and a loved one in your life require care assistance, Executive Home Care is ready to lend a hand. Find out more about the expert and compassionate senior living care that is offered in the comfort of one’s own...
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...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
MAVI CAREGIVING SERVICES LLC is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Infinite Love offers a wide range of customized services to meet the unique needs of your loved one. We serve the greater Orange, CA. You can rest assured that the health and comfort of your loved one will be managed with...
Comforting Care is an in-home service provider that assists individuals and families. We are dedicated to helping our clients lead dignified, independent lifestyles in the comfort and safety of their own homes by...
UNITED CARE, LLC. is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ACASA Senior Care - Orange County & Las Vegas understands the desire seniors have to stay in their homes and still receive the quality care they need. Our caregivers are specially trained to meet those needs and strive to...
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We provide affordable high-quality professional care and support for elders and children with special needs who wish to continue to live independently in the comfort of their own home but need a helping hand with the...
Graceful Day Home Care is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
St. Clare's Home Care, Inc is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angels For Elders offers a comprehensive array of private home care services in Orange County and Los Angeles County. We provide home care throughout Anaheim, Costa Mesa, Irvine, Newport Beach, and beyond. Our independent...
At Golden League Care LLC, we believe exceptional care feels like a champion by your side. Our experienced caregivers offer tailored assistance—from daily living support and meaningful companionship to specialized...
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AL-SHIFA HOME HEALTH CARE AGENCY is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Being an essential service provider, Amada Senior Care is here for you 24/7 as we continue to operate through COVID-19. Count on Amada’s commitment to promoting your health and safety as a factor you can control during...
Best Helping Hands provides non-medical, in-home care for Seniors and any person with temporary or permanent special needs, such as Alzheimer's, Dementia, post-operative recovery, rehabilitation assistance, etc. Services...
If you want your loved ones to be genuinely cared for.... Our Mission.... is to help families keep their loved ones at home and still have the peace of mind knowing they are genuinely cared for. Our goal.... is to help...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
California's Best Home Health Services, Inc is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
It is our mission to provide quality, reliable compassionate and affordable care to our clients. We understand that the vulnerability of the frail, elderly, or disabled individual requires the presence of a caregiver who...
Gentle Grace HomeCare is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HOMECARE KINGDOM SERVICES LLC is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angel Be With Me Caregiving Service is a home care provider that services in Anaheim, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comfort Keepers Home Care provides seniors and their families in Buena Park, Lakewood, Bellflower, Fullerton, and the nearby areas with compassionate and individualized in-home care services that enhance their quality of...
At Safe Guard Care Services, our mission is to provide compassionate, high-quality, and personalized care that enhances the well-being and dignity of every individual we serve. We are dedicated to fostering a safe,...
Welcome to Alderwood Home Care. We are a small family-owned boutique home health care agency. We support our clients with all their non-medical independent and daily living needs which includes companionship to seniors...
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...
At Golden Years Home Care Solutions Inc – San Diego, our mission is to provide compassionate, personalized, and dependable home care services that empower seniors and individuals with disabilities to live safely,...
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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.