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:
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...
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My Caregivers Inc is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Indeed provides non-medical home care services to seniors: personal care, support with mobility, help with household chores, companionship, and transportation. We also send our trained and experienced caregivers,...
At Care Ambassador, we understand that every individual has unique needs. Our dedicated team works closely with you and your loved ones to create a personalized Care plan that addresses daily living activities, ensuring...
At Havencare, we believe true care creates a safe haven of comfort and dignity. Our dedicated caregivers deliver individualized assistance—from everyday routines to heartfelt companionship and specialized care—helping...
At Interim HealthCare of San Francisco, CA, we know how important it is to be in a comfortable, familiar environment. We all value our independence, however, sometimes the best way to maintain our autonomy, or preserve...
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...
At Gentiva Personal Care, our Personal Home Care Assistance can assist with personal care, daily living necessities, and help around the home. If you or a loved one is struggling with prolonged illness, recovery from...
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...
At Interim HealthCare of San Bruno, CA, we know how important it is to be in a comfortable, familiar environment. We all value our independence, however, sometimes the best way to maintain our autonomy, or preserve that...
Professional Medical Resource started it's operation in Chicago,Illinois in 1976. PMR provides the best professional care in the field of care giving. Our professional staffs have the ability to care for the elderly...
HOME SUPPORT & COMPANIONSHIP, LLC is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Dealing with old age or disability and recovering from surgery or injury means you might need home care services. At St Mary’s Homecare Services, Inc., we understand your needs and strive to assist you. We have the best...
Providence Care- dupe is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Self-Help Home Care & Hospice is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Herewith, Inc. offers flexible, non-medical homecare services in Mississippi, providing seniors with trusted, background-checked caregivers for a variety of tasks. These services include light housekeeping, companionship,...
At Herewith we understand it is difficult finding compassionate, dependable caregiver services. We believe that families want the best for their loved one - that’s why our program includes allowing the family to...
Institute on Aging Senior Campus (IOA), CA is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Reliable is a home care agency that provides in-home caregiving support for seniors and those in need of assistance. We believe that the home is the optimum setting for healing and we are delighted to help our clients...
MELICOR HOME CARE, LLC is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ucsf Home Health Care is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OptionONE Care At Home is based in San Francisco’s financial district, and provides non-medical home care anywhere in California. We deliver reliable and compassionate based on a simple formula: We care for people the way...
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...
A Distinguished Senior In-Home Care Provider in the San-Francisco Bay area. ….who are we? Care Giver Staffing is committed to providing Senior in-home care assistance that goes beyond your expectations.To truly care...
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Health Link Home Health Agency is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Incare Home Health Services SF is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Precious Home Companion is a full service home care agency whose mission is to improve the quality of life of the people and the communities we serve by providing compassionate, reliable and exceptional home health care....
North Cal Home Health Care, Inc. is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allied Care Bay Area Home Care provide a wide range of non-medical personal care services to anyone in need of some assistance with the routine demands of daily life. Those benefiting from our services include seniors and...
Herewith, Inc. offers flexible, non-medical homecare services in South Dakota, connecting seniors with trusted, background-checked caregivers. These caregivers assist with a variety of tasks, including light housekeeping,...
HEART TO HEART SENIOR CARE, LLC is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Pure Love and Care has been providing a wide range of elder care services for over 8 years. Our family-oriented company offers one of the lowest in-home care rates in the industry. Additionally, you can cancel services at...
CareSimply is the best way for families to find and hire high quality, affordable home care. Use CareSimply’s online directory to find your perfect caregiver. Caregivers must pass a rigorous screening process that...
Kaiser Foundation Hosp Home Health - San Francisco is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Arcadia Health Care is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bay Area Care Team Inc is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advocate Homecare is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to ChoiceCare – Providing care management and in-home care services. ChoiceCare is your one-stop solution for those difficult questions concerning the care of your older love one. If your time is precious and...
Home Care ServicesHome care services allow seniors to remain in the comfort of their own home and community. We serve clients in their homes, assisted living communities, hospitals and nursing homes.Depending on the...
On Lok PACE is a full-service healthcare program that provides the services you need to age at home. Our services include home care, medical, transportation and other senior services. On Lok PACE: Empowering you to live...
IRISH HELP AT HOME LLC is a home care provider that services in San Francisco, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Care Agency with over 20 years experience serving seniors and those who wish to remain in their own homes. We are the caregiver's employer. This relieves you of additional payroll, taxes and insurance calculations....
As a boutique agency with a discerning clientele and handpicked caregivers, we pride ourselves on delivering exceptional, personalized care tailored to your unique needs. At SF Home Care, we care about the details.
It’s human nature to want to be independent and self-sufficient, but there are times in our lives when we need a helping hand. Are you a new parent and feeling overwhelmed? Are you recovering from an especially...
To preserve the dignity of our clients by ensuring an easy, personalized experience, from dedicated, passionate caregivers committed to helping others live a better life at home.
Caring is what we do. We provide the in-home care needed by any elder hoping to live a comfortable and safe life at home. We also offer specialized Alzheimer's care as well as Hospice and end of life care. All of our...
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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.