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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:
When seniors, or recovering individuals, need short or long-term care, home is always the best place for the healing to begin. With Cottage Caregivers, you can offer an aging care place for mom and dad that has the daily...
Home health care helps older adults live independently for as long as possible, even with an illness or injury. At HSH, we offer home health care that is both medical and non-medical in nature, including chores and light...
Boston Nursing Care & Consulting cultivates a modern healthcare experience, which provides our clients the knowledge and education to fully understand their conditions.
Mark Friedman, owner of Senior Helpers Boston and South Shore, has been in the senior care industry since 2009. His team is guided by a passion for senior care and a goal is to set a new standard in senior care in...
By choosing Senior Helpers for a loved one, you’re not just getting exceptional care for any of their needs, but you’re gaining a genuine, in-home connection designed to give them the absolute best quality of life. We...
We are a recognized agency providing Home Health Care wherever a client lives in Eastern Massachusetts. We are also Alzheimer's specialists. The service can be a few hours or 24 hours. We offer Live-in, hourly,...
Outreach Health’s Mission is to honor God in all we do by providing superior service and support to our clients, families, employees, and the health care community. Our Vision is to be the trusted partner in quality...
The Harbor Health Elder Service Plan offers a personalized healthcare program provided by our own geriatric professionals guided by a care plan developed and customized for the individual’s needs.
As loved ones age, their daily needs may change in ways that make living alone more difficult. Many families consider home care as a way to offer support while helping seniors remain in familiar surroundings. Choose...
At Cornerstone Caregiving in Norwood, we believe every senior deserves care that feels like family. I’m Priyanka, the Operating Director, and I bring over 30 years of experience as an occupational therapist, helping...
Allied Home Health Care, Inc is a home care provider that services in Quincy, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bayada Nurses of Quincy, MA is a home care provider that services in Quincy, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our care is very exceptional because we use our hands and hearts to focus on our clients’ needs. Our caregivers are 100% Certified Home Health aides and Certified Nursing Assistants. Prime Care Associates is a private...
Comfort Keepers of Quincy, MA is a home care provider that services in Quincy, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Physicians Homecare is a home care provider that services in Quincy, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentiva Health Services is a home care provider that services in Quincy, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
North River Home Care’s highly experienced and dedicated care staff serves clients with a variety of needs to help your loved one remain at home, including: Personal & Companionship Care, Respite Care and Alzheimer’s and...
Elderly Caregivers LLC - Connecticut is a home care provider that services in Quincy, MA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At it’s core, our in-home senior care service is about bringing warmth, friendship, and the highest quality of care right into the comfort of your home. More than just lending a hand, we’re here to share laughs,...
Your Extended Family When Family Can’t Be There At Home Helpers Home Care, we’re here to do exactly what our name says: help. We’re more than an in-home health care agency – we’re your extended family when family can’t...
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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.