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.*
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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:
This is a GREAT question!!!! I find it common that most people that have granted a POA,were not informed of details concerning this very serious legal document, and niether party has a clue of what POA is for or what to do or that the powers needed to be written on those papers are needed for an "individuals" particular situation, financially and medically or of the responsabilities expected/granted. I am a hairsdresser and before I color a persons hair there is a consultation of what is the result expected or procedure involved and care after because unless I explain they don't know these things. The clients ask a million questions and I answer to the best of my knowledge. I don't understand why these very important legal papers about a persons Lifes treasures and assets and future health concerns are accepted by grantee or granted without knowing the facts or whats to be expected. Are people afraid to ask Lawyers questions or do they just care more about thier hair than thier life in someone elses hands. Maybe if I charged $50.00 per question I bet I'd be asked less questions or clients would have more trust in my professionalism if I charged by the hour. Read the papers and it say's what you have granted. The Agent you selected should be someone, with whom you have absolutely no doubt in your (sound) mind, that they will look out for "YOUR" best interest on all matters grantor has granted. This type of person is rare: ~I would trust most Dogs to do this job in most cases better than people, Dogs give love and protection without expecting anything to gain and most Dogs will die for you without a second thought!!!~ If dogs could sign papers that is.~ Although I must say this web site has proven that there are those rare souls right here, and usually they get beat up emotionally by the untrusting, heartless, sellfish, uncareing, power hungry, greedy losers that think thier actions go without punishment. My true emotions get vented here, I have learned alot about people from this experience. So if you have found a true friend that is willing and trusting you should discuss all your wishes and concerns and have it written to your individual assets and accounts details. General wording may be a conflict with your account holders. I advise calling the legal departments for all accounts find out what they look for as far as thier legal requirements for transfers etc. Any Id's , SS card birth certificate, passport, marriage or divorce papers, your parents last names(of grantor of POA), deeds, tax forms, VET papers, income tax for prior years, etc.are all needed too. If everyone organized these things before a health issue becomes a crisis situation it would be easier on your trusted POA.
I am really concerned if you gave the POA and didn't bother to figure out what you gave her before you signed? Take it to an attorney. Have he/she explain it. If you don't like it make out a new POA and put whomever you think best as the POA.
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 would trust most Dogs to do this job in most cases better than people, Dogs give love and protection without expecting anything to gain and most Dogs will die for you without a second thought!!!~ If dogs could sign papers that is.~
Although I must say this web site has proven that there are those rare souls right here, and usually they get beat up emotionally by the untrusting, heartless, sellfish, uncareing, power hungry, greedy losers that think thier actions go without punishment. My true emotions get vented here, I have learned alot about people from this experience. So if you have found a true friend that is willing and trusting you should discuss all your wishes and concerns and have it written to your individual assets and accounts details. General wording may be a conflict with your account holders. I advise calling the legal departments for all accounts find out what they look for as far as thier legal requirements for transfers etc. Any Id's , SS card birth certificate, passport, marriage or divorce papers, your parents last names(of grantor of POA), deeds, tax forms, VET papers, income tax for prior years, etc.are all needed too. If everyone organized these things before a health issue becomes a crisis situation it would be easier on your trusted POA.
Take it to an attorney. Have he/she explain it. If you don't like it make out a new POA and put whomever you think best as the POA.