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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:
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LSSI offers in home care to meet the changing needs of seniors. Services like home care extend the time that seniors can remain independent in their homes. By caring for seniors, LSSI alleviates caretaker stress and...
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Jonathan Wishnick opened Senior Helpers of Chicago in 2009 so people who need assistance would get well trained, well managed, and smart assistants as a tribute to his mother. Jonathan makes sure every client is treated...
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Our in-home care services provide the daily support adults need to live a life of dignity with as much independence as possible in Oak Park, extending into Chicago neighborhoods such as South Austin, West Garfield Park...
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We’re here to help you continue living independently. If you or a loved one is having trouble with activities of daily living, home safety or personal care, we can provide a specialized program to make life easier and...
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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...
Our services are provided to anyone, in any situation that makes living independently more difficult. Aging, illness, or disabilities can put a person in an unexpected state of home care needs which often times can create...
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...
For 24 years, TheKey has earned the trust of more than 120,000 clients by delivering 12 million hours of personalized home care each year using our science-backed Balanced Care Method® that actively supports well-being....
We’re here to help you continue living independently. If you or a loved one is having trouble with activities of daily living, home safety or personal care, we can provide a specialized program to make life easier and...
When the time comes that extra care is required, whether due to age or health condition, many people prefer the familiarity and comfort of their own home. At Homewatch CareGivers®, we believe that good care should not...
Elara Caring - Chicago, IL is a home care provider that services in Chicago, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In-home care services can help people at any point within the aging process. We’ll work with you to develop a personalized care plan tailored to help fit your family’s needs. Our expert care provides all the support...
Optimum Senior Care Optimum Senior Care offers in home senior care and caregiver services to the elderly population in the Chicago Metro area. Our mission is to cherish and protect the independence and dignity of our...
At HomeWell, we address the immediate needs of clients while anticipating future challenges to bolster and protect their well-being as they age. We are dedicated to the long-term effects of a masterfully-crafted care...
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Angel Care's approach to home care is "Care Coordination". We are dedicated in helping patient remain and thrive at 'home'. We are committed in providing high quality, client centered and affordable home care service to...
Acacia Home Health Agency is a home care provider that services in Chicago, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Agile Home Health Care, Inc is a home care provider that services in Chicago, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ace-Premier Home Care Services, Inc. offers compassionate and personalized in-home care for seniors and individuals with disabilities. Our skilled caregivers provide assistance with daily activities, medical support, and...
Advance Level Care, Incorporated is a home care provider that services in Chicago, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Accurate Care At Home , Inc. of Chicago, IL is a home care provider that services in Chicago, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Amedisys Home Health is a home care provider that services in Chicago, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Jennifer Novy, owner of Amada Senior Care North Shore, has dedicated her professional and personal life to caring for seniors. As a life-long Chicagoan, she now uses her senior care experience to help neighbors in Lake...
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 of Greater Chicagoland is the premier provider of in-home senior care. We offer tailored home care services ranging from companion care for seniors who need daily assistance to in-depth specialized care for...
At Senior Helpers of Elmwood Park, we are dedicated to providing exceptional in-home care services that promote independence, dignity, and a higher quality of life for our clients. Our compassionate and highly trained...
Access Health Medical Supplies and Home Health Inc. is a trusted provider of high-quality home care services for seniors, offering compassionate and professional assistance to help older adults maintain their independence...
Home & Hearth Caregivers is available 24/7 for you or your loved one. We serve Cook, DuPage, Kane, Kendall, Lake, McHenry and Will counties. Our experienced Care Plan Managers will be happy to provide a complimentary home...
North Shore Compassionate Care is the ideal solution for elderly or disabled individuals who want to maintain their independence and dignity by continuing to live in the comfort of their own homes. Our home health...
Senior Helpers North Side Chicago is a mother and daughter run business. We are proud to be 100% female owned. We come from a big family and love being part of a business that supports and promotes the well being of...
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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.