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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:
Here at Quality comfort we provide personal care, such as getting in and out of bed, walking, bathing, and dressing. We offer personal care services can provide aides that also help remind you to take your medicines, do...
When you have an aging family member in Greenwood, IN who may benefit from senior care, Senior Helpers Greenwood is here to help. At Senior Helpers of Greenwood, we offer comprehensive care, and can tailor a package that...
**PNA Nurturing Care Service LLC** in Brownsburg, IN, provides non-medical home care services, offering personalized assistance with daily living activities and companionship to seniors and individuals with disabilities....
Unconditional Love Caregivers LLC in Indianapolis, IN, offers compassionate, personalized home care services designed to enhance the well-being and independence of individuals in the comfort of their own homes.
I wanted to take a moment to explain why I believe my business is highly qualified to be your private non-medical home health agency. We specialize in providing personalized care that helps seniors and individuals with...
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...
Making a Difference Home Care, LLC in Indianapolis, IN, is a home care provider that likely offers a range of services aimed at helping individuals maintain their independence and quality of life while receiving care in...
At Dependable Living, we are committed to empowering individuals to lead vibrant, secure, and fulfilling lives. Our mission is to provide unparalleled support and resources that enable our clients to navigate the...
At Amada Senior Care of Greater Indianapolis, our goal is to walk with seniors and their loved ones through every step of their senior care journey. They are committed to preserving dignity and giving families the peace...
Welcome to Reason To Love Home Care Agency LLC, your go-to home care services provider in Indianapolis who are looking for comfort and peace of mind. We provide a range of services tailored to meet the specific needs of...
At Vesta Structured Family Care, we extend beyond traditional care services; our foundation is built on compassion and a personalized approach to support. We are passionately focused on serving seniors, driven by a...
At Prestige Loving Home Care, we are committed to delivering exceptional service to your loved ones. With a dedication to personalized care, we ensure every client experiences comfort and peace in their home and lives an...
Our talented staff is here to assist you and your loved ones. We have experienced nurses who have the ability to work with all patients no matter their expected needs. Based in Indianapolis, IN, we service 80% of the...
Our mission is to provide you with the finest quality in non-medical in-home support and care. We strive to serve the people in our communities by affirming life and the dignity of our patients with a variety of services....
Gratitude Home Services is likely a home care provider committed to delivering personalized, compassionate care to individuals in the comfort of their homes. Their focus is on supporting clients' independence, health, and...
Established in 2021, MAGNIFICENT HOMECARE LLC pays homage to the owner’s late sister, who courageously battled SMA and required constant in-home care. Her enduring journey profoundly inspired the core mission of our...
We Make A Difference In Senior Lives At Happy Homes Homecare, we are dedicated to providing exceptional in-home care for seniors. Our mission is to ensure that every senior receives the care, respect, and companionship...
Transforming Love Homecare is committed to making a positive impact on the lives of our clients and their families. By focusing on compassionate care and maintaining the highest standards of service, we aim to be the...
BETTER HOMECARE SERVICES LLC is a home care provider that services in Greenwood, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OUR MISSION The mission of our company is to provide quality and reliable home care services in the comfort of a client’s home surrounded by their loved ones
Robins Home care Test is a home care provider that services in Greenwood, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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,...
St. Francis Home Health and Hospice is a home care provider that services in Greenwood, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Executive Home Care, LLC of Greenwood, IN is a home care provider that services in Greenwood, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mission Statement: MarZaz Health Care LLP mission is to provide professional services to our clients in the comfort of their homes by assisting them to achieve the highest level of potential in their daily care. We are...
BRIGHTNESS HOME CARE LLC is a home care provider that services in Greenwood, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Team Select’s mission is to change lives for the better. We advocate for families in need, treat our patients like the heroes they are, and empower our team members to make the world a better place. With more than 15...
Advanced Home Care Plus Llc is a home care provider that services in Greenwood, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CORNERSTONE CAREGIVING IN INDIANAPOLIS, INDIANA We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Indianapolis or in surrounding areas like...
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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.