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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:
About Epic Home Care Services It is our commitment to ensure that each person we care for is able to live in their own home and be as independent as possible, while taking into consideration the unique needs of each...
Staying at Home is now a Choice You Can Keep. We fully support you in your decision to stay at home. Our services are designed to help you be more comfortable and at ease in your own home. We are also available whenever...
At Priority Home Care, we understand that each individual has unique needs and preferences. That’s why we’re committed to providing personalized solutions tailored to you or your loved one. Our dedicated team of...
At EMIC HEALTHCARE, we started with a simple idea: to provide reliable and compassionate home health care services to those in need. We are a licensed private home care service agency in Georgia destined to be a trusted...
Senior Solutions is a non-medical comprehensive home care agency that trains caregivers who assist our clients with activities of daily living in their own homes. In recent years, we have also added service lines to help...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Charlotte Web Private Home Care, LLC is a home care provider that services in Kennesaw, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
MainSpring Home Care is committed to providing high-quality, affordable, and compassionate Private Home Care Services that meet the needs of our clients and their loved ones in the comfort of their own homes.
At Amada Senior Care Atlanta, we constantly look for ways to bring enjoyment to clients’ lives by making even the most common tasks and activities special. Our in-home caregivers form close bonds with clients as well as...
CareBuilders at Home is a premier provider of in-home care services, dedicated to enhancing the quality of life for seniors and individuals with disabilities.
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Quality, trust and compassion are the foundations of 4 Seasons Home Care. Owned and operated by a registered nurse, our caregivers enhance the lives of seniors across the Atlanta area.
Georgia Peachcare Service provides personalized, high-quality home care services to seniors and individuals with disabilities. Our dedicated caregivers offer assistance with daily activities, companionship, and support to...
Welcome to Edens Care, your trusted partner in providing exceptional in-home care and professional medical staffing solutions. With a passion for enhancing lives and a commitment to excellence, we are dedicated to...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Senior Helpers of Marietta places a priority on creating safe, caring and compassionate environments for all clients, while providing ongoing communication and follow-up plans which offer peace of mind for family members....
Arose Home Care Services LLC, located in Powder Springs, GA, provides compassionate non-medical home care services. They assist individuals with daily living activities, including personal care, meal preparation,...
Hearts of Love Caregivers helps families with non-medical in home care. We offer in home health care in select locations. With Hearts of Love Caregivers, every client receives extra ordinary care from our caring team. We...
Your nearest All Ways Caring office is your gateway to all of our quality services, programs and support. Each local office provides the staffing, resources, commitment and experience to ensure that your loved one can...
Home Instead Kennesaw has been providing extensive in-home care services in the Atlanta area for over 15 years. Home Instead can tailor a home care arrangement to fit both your family's lifestyle and budget.
At Righteous Hands Personal Care Agency, we pride ourselves on providing exceptional in-home care services throughout Georgia. We understand the importance of offering compassionate and purposeful care to our clients.
Ahava Hospice & Homecare Services is a home care provider that services in Kennesaw, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ms. Jackie`s Home Care & Services is a home care provider that services in Kennesaw, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CARING HANDS HOMECARE NURSING SERVICES is a home care provider that services in Kennesaw, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alternative Healthcare LLC, based in Powder Springs, GA, provides compassionate in-home care services aimed at enhancing the quality of life for our clients. Our skilled caregivers deliver personalized care plans,...
Loving Healthcare is a home care provider that services in Kennesaw, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Helping Hearts Home Care was founded in 2012 by a former assisted living coordinator. We are family owned and operated. Helping Hearts provides award-winning in-home care for seniors and other adults in need of assistance...
Tranquil, Inc - Kennesaw, GA is a home care provider that services in Kennesaw, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are passionate in care and compassionate about People and that’s why we provide the specific personal services necessary to make your daily living more carefree, enjoyable, and rewarding. We understand that the...
Family to Family Home Care is a home care provider that services in Kennesaw, GA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Happy Life Home Care provides solutions for your personal care. Your comfort is our priority. Be it in a private home, assisted living, rehabilitation center or nursing home, Happy Life Home Care's commitment is to...
At Brighter Times Inc. we believe that every individual deserves to live their brightest life, even when facing challenges that come with aging or illness. That's why we offer personalized in-home care services that are...
Maurina Homecare Agency was founded by a Family Nurse Practitioner and a military servicing member. Having worked in the healthcare field, I have witnessed the essence of providing high-standard care in the comfort of...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
We provide professional, personalized care services to individuals in the comfort of their own homes, offering support for daily living activities, medical needs, and companionship. These agencies typically employ a team...
We know you have countless choices when it comes to selecting your care provider. At Esther Home Care, when we say, “Serving Families Is Our Pleasure,” we mean it. You are at the heart of our service! We respect and take...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment
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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.