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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.
✔
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:
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Licensed for Hands on Care and Companion Services Fully Insured Licensed by the Department of Health and Human Services Division of Health Services Regulation Covering 14 counties out the Raleigh office: Wake, Alamance,...
It doesn’t matter if you’re here because you’re looking for help living independently, or if you want to make sure someone you love has the support they need to stay in their home. We believe there’s more to caring for...
QUALITY SENIOR CARE AT HOME The Senior Care market is a rapidly expanding industry that continues to be competitive. We differentiate ourselves every day with the quality of our senior care services, how we speak and how...
At Griswold Home Care for Raleigh, we offer compassionate in-home care for those who want support to live where they love. With over four decades of experience and a storied legacy of compassion and integrity, we focus on...
Our Story Home—there’s no place like it. It’s where your memories are. Where you raised your family and where friends have gathered for life’s celebrations. It’s been your basecamp through good times and bad. And it’s...
We believe seniors deserve to choose how, when, and where they receive care. We understand true comfort comes when people feel seen and understood. Our process is to put you and your loved one in the center.
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...
At Friendly Forever Homecare, we are deeply committed to redefining the standards of care for our clients. Our services cater to individuals’ diverse needs, ensuring that they receive the utmost care, support, and...
You’ve probably seen it with loved ones. An elderly person checks out of a hospital or nursing home only to be readmitted within a few months. During the transition, medications weren’t taken, doctor appointments...
At BellaCare Solution, our mission is to provide compassionate and personalized private home care services across Raleigh. We offer quality home care that improves the lives of our clients while supporting their...
Always Best Care - Raleigh, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
A1-Omega Health Services is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. In select markets we've also added skilled home care for clients that suffer from illness...
At Amada of Raleigh and Eastern North Carolina, we provide non-medical in-home care for seniors. We know how important it is for our clients to continue to do the things they love at home, so we help make life easier and...
We Offer Independence Abiding Care is dedicated to enhancing the lives of seniors, individuals with disabilities, and those who need temporary assistance through our comprehensive home support services, empowering our...
We know there’s no place like home. That’s why HomeWell brings you the highest quality of care so you can maintain your independence and experience life to the fullest.
Caregiver shortages, escalating costs, improvements in technology, Increased regulation, and a new cultural mindset have combined to make it advantageous for families to hire experienced, independent caregivers directly....
As a home nursing care provider in Claton, North Carolina, we provide services to support patients in their homes. We begin by learning and understanding their needs through a comprehensive home assessment. Then, we...
Tender Loving Touch Senior Care is a home care provider that services Raleigh, NC 27609. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care...
At Senior Helpers of Holly Springs, we specialize in providing personalized, non-medical care tailored towards meeting the unique needs of each individual client. Our mission is to foster independence while ensuring...
Ally Health Services, LLC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AlbertaCare LLC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care by Your Side & Services, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care offers a wide variety of high-quality services—from in-home care to medical staffing. If you are looking for a trustworthy care provider or staffing partner in the Midtown Raleigh / Durham, NC area, please...
Above The Horizon Home Care LLC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allcare Home Health Agency, was established because of our passion for taking care of seniors, disabled and special need adults. Our agency is composed of a multi-disciplinary team of nurses, home health aides, care...
All Time Health Care Inc. is a licensed home care agency based in Raleigh, North Carolina, providing in-home care services to individuals with functional, physical, or mental impairments.
BrightStar Care of Raleigh, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Arcadia Home Care & Staffing is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bluecross Home Care and Health Services Inc. is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amen Home Care Agency, LLC is a reputable, Raleigh-based nursing care agency providing in-home skilled nursing services—staffed by RNs and LPNs—for private-paying clients. It’s a licensed, locally operated business ideal...
Our In Home Personal Care Services include, but are not limited to Bathing Dressing Toileting Life enhancing activities Alzheimer’s / dementia care Incontinence care Meal preparation Feeding assistance Medication...
American Medical Equipment & Supplies, Inc. is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bright Home Care Services, LLC is a home care provider that services Raleigh, NC 27610. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
A-1 Helping Hearts Home Care Agency, LLC is a home care provider that services Raleigh, NC 27604. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allied Home Health Care Services, Inc. is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aspire HomeHealth Services,LLC We're committed to providing compassionate care and support to individuals and families in our community. We understand that navigating the complexities of healthcare can be overwhelming,...
AccordCare - Raleigh, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
AlbertaCare of Wilson, NC provides compassionate in-home care services that help seniors and individuals remain safely at home. Caregivers assist with personal care, companionship, meal preparation, medication reminders,...
Options Home Care of Cary is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Raleigh or in surrounding areas like Wake Forest, Garner, or Forest Hills.
One You Love Homecare Chapel Hill and Raleigh, NC is a home care provider that services in Raleigh, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Stay at Home Senior Care and our legacy Family of Providers have had the privilege of serving families and seniors for over twenty years. We have built a network of extraordinary homecare provider agencies that...
Our Services -Companion Care For our basic level of care, caregivers provide services such as companionship, meal planning and preparation, light housekeeping, laundry, medication reminders, and other general assistance....
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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.