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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:
Quality, trust and compassion are the foundations of Southern Crescent Care, LLC. Owned and operated by a registered nurse, our caregivers enhance the lives of seniors across the Atlanta area.
At Empathic Touch Health LLC, we believe in a holistic approach to care, ensuring each client feels valued, safe, and supported in the comfort of their own home.
BrightStar Care offers a wide variety of high-quality services—from in-home care to medical staffing. If you are looking for a trustworthy care provider or staffing partner in the Locust Grove & McDonough, GA area, please...
Whether providing short-term assistance or long-term support, our team is committed to enhancing well-being and fostering peace of mind for both clients and their families.
Our in-home care services brighten the lives of seniors, who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier through compassionate support,...
Right at Home caregivers provide assistance so you can live comfortably at home. More importantly, our caregivers promote healthy living and well-being through the benefits of social interaction. Contact us today at (678)...
Healing Haven Home Care stands out from the rest through our unwavering commitment to personalized care and holistic well-being. We take pride in seeing you as a whole person, not just a customer. We believe in treating...
Kitchen's Home Care LLC, Compassionate In-Home Care Services At Kitchen's Home Care LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence....
Charlotte Web Private Home Care, LLC is a home care provider that services in Hampton, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Hopeful Haven Home Care, LLC, our mission is to provide compassionate, high-quality home care services that enhance the dignity, independence, and well-being of every client we serve. We are committed to delivering...
Home plus care delivers reliable, compassionate in-home support that adds comfort, safety, and peace of mind to everyday living. Caregivers provide personalized daily assistance and companionship—helping clients stay...
Cornerstone Caregiving is proud to serve Fayetteville and its surrounding areas, offering exceptional in-home care services. Our caregivers take the time to get to know each client individually, providing personalized...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
TURNING POINT HEALTHCARE SERVICES LLC is a reliable home health care agency that is built and established with trust, quality, and compassion. We serve the Georgian residents who are experiencing treatable and manageable...
Living Well Personal Care Home Agency, located in Georgia, is dedicated to providing personalized in-home care services that enhance the well-being and quality of life for seniors. Our experienced and compassionate...
LCH PHC is dedicated to helping you or your loved ones stay safe and independent in the comfort of familiar surroundings. Our in-home care services are tailored to support individuals facing a variety of health challenges...
Precision Private Home Care is a home care provider that services in Hampton, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
PLOI (Placing Love Over Interest) Excellent Healthcare Services is an Outstanding Homecare Agency and here to provide an unparalleled experience as the most trusted partner for healthcare. Providing Skilled and...
Our agency is committed to ensuring high-quality patient care through high-standard and evidence-based medical care. We follow the rules and regulations established by local and international accrediting and governing bodies
Marchenrich Wellness Services LLC is a home care provider that services in Hampton, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome A little help could go a long way. We understand, and we are here to help with reliability, professionalism, and kindness. We send trained aides to the homes of our clients to provide support with activities of...
TRIBRIDGE HOME HEALTH SOLUTIONS LLC is a home care provider that services in Hampton, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Whether you need daily health related attention or are looking for respite care — you name it, we do it! Our qualified caregivers are here to work with you and your doctor to develop and manage a personalized home health...
Wolistic Healthcare System is a home care provider that services Hampton, GA 30228. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
GOD'S LOVE HOME CARE LLC is a home care provider that services in Hampton, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Zion Healthcare Services LLC is licensed by the State Department of Community Health Services. Our personnel are thoroughly screened and background checks are done, to ensure professional and caring services delivery to...
Caregivers You Can Trust Feel better in the comfort of your own home. We specialize in Home Care daily or living assistance to an array of individuals. Whether you need daily or weekly assistance due to aging, illness,...
Providing compassionate and professional care tailored to individual needs, our home care agency offers comprehensive support for clients in the comfort of their own homes. With a dedicated team of trained caregivers, we...
Our Mission Our mission is to enhance the well-being of our clients by delivering the highest standard of personalized, home-based health care. We strive to create a supportive environment where clients can feel safe,...
FirstLight Home Care delivers loving and compassionate care to seniors in Atlanta in the comfort of their own home. Our team's "Culture of Care" helps people age independently with confidence, dignity and happiness.
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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.