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.*
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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:
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,...
At AB Royal Home Care Services Inc, our mission is to provide compassionate, dependable, and personalized in-home care that supports each client’s independence, dignity, and quality of life. We are dedicated to delivering...
Uneek Angel provides compassionate, dependable non-medical home care designed around each client’s unique needs. Their dedicated caregivers assist with personal care, companionship, meal preparation, light housekeeping,...
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...
We are dedicated to connecting individuals and families with trusted caregivers who provide dependable, personalized support that inspires confidence, fosters independence, and improves everyday quality of life, allowing...
At Prestige Loving Home Care, we are committed to delivering exceptional service to your loved ones. With a dedication to personalized care, we ensure every client experiences comfort and peace in their home and lives an...
SYNERGY HomeCare of Northern Indianapolis is owned and operated by Trent Terry, a Master’s graduate in Business Administration who has since put his degree to use in multiple successful entrepreneurial ventures, ranging...
At Amada Senior Care of Greater Indianapolis, our goal is to walk with seniors and their loved ones through every step of their senior care journey. They are committed to preserving dignity and giving families the peace...
Your independence matters. Griswold Care Pairing for North Suburban Indianapolis helps you find a Caregiver who can make everyday life at home easier without taking over the things you still enjoy doing yourself. From...
We’re always there when you need us – ready to provide care in all ways. When faced with the decision to provide care, you need a trusted partner. One who has the knowledge gained from years of providing quality home care...
Matt spent his career in healthcare long before he considered owning a business. He holds a Bachelor of Science in Public Health and a Master of Health Administration, both from Indiana University, and built his...
Nurse Next Door is a senior home care service with heart. Our kind caregivers make lives better for clients where they’re the most comfortable: at home. With 24/7 availability, total flexibility and everything managed for...
Comfort Keepers of Anderson, IN. 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...
Right at Home Indianapolis North provides personalized in-home care that helps older adults live safely, comfortably, and independently at home. From companionship and personal care to specialized dementia support,...
Right at Home Southeast Indianapolis provides compassionate, personalized in-home care that helps older adults remain safe, independent, and connected to the life they love. From companionship and personal care to...
At Right at Home Indianapolis West, we understand that every journey is unique. Whether you’re here seeking support to live independently, or you’re looking for peace of mind knowing a loved one is in capable hands, our...
Locally owned and operated, Senior Helpers Greenwood, IN is dedicated to creating a great match between the caregiver and the family. No matter the type of in-home care your loved one requires, trust the team at Senior...
Luma Home Care provides compassionate, person-centered care designed to help seniors maintain their independence, dignity, and quality of life. The team works closely with clients and families to create personalized care...
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,...
You Deserve the Best Care Available With over 10 years of experience, we have proudly provided exceptional in-home, non-medical care to individuals and families throughout Indianapolis and the surrounding suburbs. Our...
Helping Hands Home Management LLC is a home care agency based in Indianapolis Indiana that provides in home care services focused on helping clients maintain independence dignity and quality of life. It develops...
To be Indiana’s most trusted home care provider, delivering compassionate, personalized support that empowers individuals to live with dignity, independence, and enhanced quality of life in the comfort of their own homes.
T 3 Home Services is a trusted private pay home care agency in Indianapolis, IN. We assist with ADLs like bathing, dressing, grooming, and mobility, plus IADLs such as meal prep, medication reminders, light housekeeping,...
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...
Advantageous Care LLC is an Indianapolis-based home health agency dedicated to helping individuals remain safe, comfortable, and independent at home. The agency provides personalized in-home support designed around each...
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...
The agency is committed to being a reliable resource for families seeking quality in-home support for their loved ones. Through compassionate service and a client-centered approach, A Veterans Touch Homecare Solutions LLC...
Comfort Keepers of Anderson, IN. 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...
At Guardian At Home Care Services LLC our commitment is to transform the way in-home care is experienced by blending compassion, excellence, and truly personalized support. Our mission is to help individuals live safely...
We work closely with families to create customized care plans that meet each client's unique needs, providing peace of mind and exceptional care every step of the way.
Nurse Next Door is a senior home care service with heart. Our kind caregivers make lives better for clients where they’re the most comfortable: at home. With 24/7 availability, total flexibility and everything managed for...
Care When and Where It’s Needed Our home care services are available 24 hours a day, 7 days a week, 365 days a year, so you know your loved one’s needs are always being met. We offer care when and where it’s needed,...
A Heart of Gold LLC, Compassionate In-Home Care Services At A Heart of Gold LLC, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence. Our...
A HOME CARE NEAR YOU INC is a home care provider that services in Indianapolis, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
7STAR HOME CARE LLC is a trusted provider of personalized home care services for older and younger clients. Our dedicated care agents offer a wide range of assistance, from companionship to specialized support, to help...
A Shoulder To Lean On Home Care Services LLC is a home care provider that services in Indianapolis, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At A Call Away Homecare LLC, we are proud to offer a wide range of comprehensive nonmedical personal care solutions, backed by our expertise. Our goal is to provide you and your loved ones with the highest quality of...
A PLUS HOME CARE INC is a home care provider that services in Indianapolis, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A LOVING WAY HOME CARE SERVICES LLC is a home care provider that services in Indianapolis, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Joyful Journey Home Care is a compassionate home care provider dedicated to enhancing the quality of life for seniors and individuals who need support to remain safe, comfortable, and independent in their own homes....
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...
Our mission at Yay Bella Homecare Agency is to provide exceptional non-medical in-home care services that promote independence, dignity, and quality of life for our clients. We are dedicated to delivering compassionate...
Senior Helpers Indianapolis helps families navigate the full continuum of senior care. Our in-home aides allow seniors to receive the day-to-day help with personal care they need and assistance with activities of daily...
CORNERSTONE CAREGIVING IN INDIANAPOLIS, INDIANA We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Indianapolis or in surrounding areas like...
We’re intentionally different. We set the benchmark for excellent home care by balancing our friendly nature, person-centered approach, and discreet services with our love of helping you maintain your independence. It’s...
Our team is dedicated to providing superior care with a focus on safety and respect. We understand how important it is to have confidence in the care your loved one is receiving and we are here to provide that for you.
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...
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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.