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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:
Graceful Living Care is an Ohio-based non-medical senior home care agency dedicated to helping seniors live safely and comfortably at home. With over 20 years of hands-on caregiving experience guiding our leadership, we...
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...
Home Health Care by Callos mission is to provide professional and paraprofessional services to patients in their homes assisting them to achieve the highest level of potential in their day-to-day self-care activities. We...
Home Preferred Home Care Ltd is dedicated to delivering high-quality, compassionate in-home care that prioritizes the comfort and well-being of each client.
Nurturing Us All LLC, led by lifelong caregiver Vera Willie, offers compassionate, client-centered home care with rigorous caregiver screening and hands-on oversight. Vera brings over two decades of experience and a true...
Northeast Professional Caregivers - OH is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advantage Home Health Services, Inc is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Preferred Home Health is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A UNIQUE FAMILY UNDIVIDED LLC is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Maxim Healthcare Services, Inc is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ACTION HOME CARE LLC is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Niki Hall Provider is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CANVAS HEARTS LLC is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Legacy Residential Services LLC offers comprehensive non‑medical in‑home supportive care, focusing on both personal care (ADLs) and household assistance (IADLs), alongside supervision/coaching to help clients maintain...
Ohio Care Response Home Health Agency, Corp is a home care provider that services in Canton, OH. 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,...
Vision Our vision is to provide people across the country with exceptional home and community-based services and offer our teammates fulfilling careers, honoring each individual’s unique aspirations.
At Aegis Royal Care, our mission is to deliver dignified, personal care, companion care, senior health care, and luxurious non-medical home care that empowers our clients to live gracefully at home. Led by experienced...
Are You Looking for Compassionate Care for Yourself or a Loved One? You comfort, dignity, and well-being are our top priorities. At Waymaker Homecare, providing personalized care right in the comfort of your home....
A Brighter Dawn, Inc. is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Absolute Skilled Home Health, Inc is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Guardian Angel Home Care, Inc is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home - Canton, OH is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
Seniors Helping Seniors - Canton and Eastern Stark County, OH is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Kingdom Cares is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ideal Home Health Care, Inc is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mercy Medical Center Homecare is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cambridge Home Health Care, Inc is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Northeast Professional Home Care is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Blended Family Health Care Services LLC is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Health Care In Your Home is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Northeast Professional Home Care, Inc. is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OCal Home Care is a home care provider that services in Canton, OH. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Helpers makes life easier by providing personal care services to the elderly, new moms, and their families, and people recovering from illness or surgery. Service is customized to fit individual needs, from morning...
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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.