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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.*
✔
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:
The Chosen Home Healthcare provides compassionate, personalized in-home care throughout Cleveland and surrounding areas, offering flexible hourly and 24-hour support including assistance with daily living activities,...
Your Well-Being Is Our Ultimate Goal Your comfort, safety, and happiness are at the heart of everything we do. We treat you like family and will design a program that you are happy with!
Omni Park Home Care is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Xpress Home care and Health services is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mission: To provide our clients with the best quality of life that is achievable. We shall treat each of our clients with respect and dignity they deserve, as though we were caring for a member of our own family....
Pinnacle Senior Care is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
HEAVEN'S HOME HEALTH CARE LLC is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Willcare is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
MedSource Home Care is a locally owned and managed home health care company striving to meet the needs of Cleveland's inner city, and surrounding suburban seniors.Our mission is to provide the highest quality care for...
Home Caregivers Bringing High Quality Care to You Aides Helping Hands Home Care is the most reliable and trustworthy Home Care Agency service in the greater Cleveland area — providing excellent home care solutions to...
MAGNIFICENT CARING HEARTS HOME HEALTH AGENCY is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heart Home Care, Llc is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bless-J Home Care located in Euclid, Ohio provides home care for the seniors and families in Lake and Cuyahoga counties. We value each person's uniqueness and recognize the importance of diversity among our staff and...
Our Services Include: Personal Care & ADLs: Assistance with activities of daily living, such as dressing, grooming, and personal hygiene. Bathing & Hygiene: Gentle support with bathing, skin care, and maintaining...
Home Sweet Home Ace Care offers compassionate, personalized in-home care services tailored to meet your needs. Our dedicated caregivers provide assistance with daily activities, ensuring safety, comfort, and peace of mind...
Welcome to Braxton Manner, we are dedicated to improving the lives of our patients by providing exceptional home care services. We are committed to delivering personalized care and support, ensuring that each individual...
Adunni Home Health Agency LLC is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mporess Home Care is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Willcare is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Multicare Home Health Services is a home care provider that services in Euclid, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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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.