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:
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...
Neighborly Home Care provides a comprehensive range of personal care services to assist seniors or anyone who needs help with activities of daily living, in their home or residence. We understand that maintaining your...
For those who wish to age peacefully or recover in a comfortable and familiar environment, HomeWell Care Services is committed to bringing you the highest quality of non-medical care and everyday support wherever you call...
Formosity Support Services, LLC is a non-medical home health agency with over 10 years of experience providing compassionate and reliable care. They are dedicated to helping seniors and individuals with disabilities live...
The entire professional care team at Amada Senior Care Philadelphia West Suburbs understands the importance of quality senior care that helps aging adults thrive and live safely and independently. Choosing the right home...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
Vital Guardian Healthcare LLC is a home care agency based in Gilbertsville Pennsylvania that provides in-home support services designed to help adults remain safe comfortable and independent in their own homes. The agency...
Neighborly Home Care - Ardmore is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Discover the Senior Helpers' Difference. At Senior Helpers, compassionate care and dedicated service can make all the difference in the lives of seniors and their families. Our owner, Kevin Herman, embodies this...
Mission Statement Delight Human Services LLC is committed to providing an ethical living environment for their staff, individuals, and their loved ones. As the saying goes “love is life”, we are committed in providing...
CARE FIRST NURSING, INC. is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Passionate Friends Caregiving Agency provides heartfelt, reliable in-home care tailored to your loved one’s needs. Our compassionate team supports seniors with daily living, companionship, and dignity—ensuring comfort and...
Continuous Home Care Inc is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
UNIVERSAL FAMILY HOME CARE is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nova True Homecare, LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nation wide home care services is a name families can trust to provide the best home care for their loved ones. We have been a leading elder care provider since 1998. Our professional and dedicated caregivers proudly help...
EDEN HOME CARE LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TLC Agencies LLC is an in-home personal care agency dedicated to providing compassionate and professional care to individuals in the comfort of their own homes. Specializing in personalized services, the agency offers a...
The Mission of the Health Angels Home Health Services LLC is to enable patients under our care to live independently and retain a sense of freedom of choice as they age. Our specialists work closely with the patient,...
NEW HOPE HOME CARE, INC. is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
4Ever Eva & Ava Homecare is a trusted homecare agency committed to providing compassionate, personalized care to seniors and individuals in need. Our dedicated caregivers support clients with daily activities, ensuring...
BESTCARE HOMECARE OF PHILLY INC. is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Udy Home Care Services LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Roka Homecare Services LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
YOUR DREAM HOMECARE, LLC. is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We simplify the process of hiring a caregiver How it works- Determine your needs Identify where and when you need help at home. Personalize your plan Tell us the in-home services you need to ensure you are...
Alyosha Home Care LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are committed to improve the quality of life of each patient by delivering ultimate health care and support services geared toward an individual care facility focusing on mind, body, and soul.
At Always United Care LLC, we believe every person deserves to age with comfort, dignity, and love. Our caregivers go beyond routine support—building meaningful relationships and providing peace of mind for families....
Passion Home Health Care is a home health care agency in Upper Darby, Philadelphia. We are licensed to provide home care services in Philadelphia County, Delaware County, Montgomery County, Chester County, and Bucks...
Greater Love Home Care of Upper Darby, PA is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Magenta home care services, inc. is committed to providing high quality, Client centered and affordable home care services to our clients to assist them to lead dignified and independent lives in comfort and safety of...
Caring Together Companion, Compassionate In-Home Care Services At Caring Together Companion, LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and...
Preferred Care at Home of Upper Darby, PA is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Hand Home Care, LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AD Homecare Services, LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CONNECTING THE DOTS HOME CARE, LLC. is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Care and Staffing Services, Inc. of Upper Darby, PA is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Our mission is to provide quality services to our clients so that they can be safe and healthy at home with their loved ones. Whether you want to be part of our agency as clients or caregivers, we promise to treat you...
Complete Healthcare Services Inc is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DIALLO HEALTH CARE SERVICES is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a trusted home care agency in Upper Darby, Pennsylvania. We are a privately owned and operated provider, serving the counties of Montgomery, Philadelphia, Bucks, Chester, and Delaware. Our home care services cater...
Who We Are Non Medical Home Care Experts Here to Serve You AD Homecare is the most Reliable, Trustworthy Home Care Agency Service in Philadelphia Area — providing excellent home care solutions to seniors and...
Attentive Home Care is a licensed home care agency that was founded in 2010 to support seniors and individuals with physical and intellectual challenges who are dealing with sickness at home, recovering from an illness,...
Covered By Grace Homecare, LLC is a home care provider that services in Upper Darby, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
KeyState Home Health is guided by integrity, empathy, and excellence in all aspects of care. We are passionate about making a positive impact on the lives we touch, offering peace of mind to families, and supporting our...
Modern Health Home Care is a premier home care agency established to provide the Highest Quality Care to our clients. Our staff shares a deep-rooted commitment to compassionate and attentive care. We take great pride and...
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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.