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.*
✔
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:
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...
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CareBuilders at Home has been recognized as a leader in senior home care. Our people are the reason why. We know that you and your loved ones place a great deal of trust in us when you choose CareBuilders as your senior...
A Place at Home Allen is here to provide you with compassionate professionals to assist you or your loved ones throughout the aging process. We strive to provide seniors with the ability to age with dignity and respect...
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At CHRISTY GRACE HEALTH CENTER INC, we focus on providing the highest standards of clinical care with compassion. We offer a variety of comprehensive healthcare services in the comfort of our clients’ homes. We provide...
Herewith, Inc. is a nationwide platform connecting families with caregivers for in-home non-medical assistance. In Texas, they offer flexible senior care services through a network of "Caregivers" who assist with tasks...
At A Plus Personal Home Support LLC, our mission is simple — to provide quality personal assistance services with compassion, respect, and professionalism. We believe that every individual deserves care that enhances...
At Christian Companion Senior Care, we have been providing reliable and affordable in-home care services to clients in Dallas, Rowlett, Sachse, Wylie, Rockwall, Richardson, Plano, Garland, Mesquite, Forney, Fate, Royse...
Ruth's Patient Care Solutions Inc is committed to delivering compassionate care through trained and dependable caregivers who prioritize respect, empathy, and professionalism.
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Home Care Book is a home care provider in Dallas-Fort Worth TX founded by professionals with national experience in healthcare. After reviewing countless home care and healthcare delivery models, Home Care Book was...
New Horizon Caregivers is a family-founded provider of trusted in-home care for seniors in Dallas and North Dallas. For nearly 20 years, we’ve supported older adults with compassionate, reliable at-home care that helps...
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Homewatch CareGivers of North Dallas, TX is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We Provide Care That Keeps You Safe at Home When a loved one becomes weak, recovering from illness, or at risk for falls, home can suddenly feel unsafe and overwhelming.
Right at Home Lewisville believes there is far more to caring for people than simply providing in-home assistance. You deserve a care partner who understands the journey ahead and will help you navigate every step....
Hello! We are Marshall & Kacy Oden and we would like to welcome you to the Griswold Home Care Office of Garland, TX. We independently own and operate the Garland office and are very proud to offer affordable, high...
Eric vanGoethem, Owner of Amada Senior Care Dallas, has made it his mission to help seniors live safely and comfortably for as long as they can in the comfort of their own homes. Eric deeply empathizes with families who...
Whether it’s helping with chores, providing medication reminders, or meal assistance, ComForCare gives you the freedom to focus on spending quality time with your family members and loved ones.
At Home Halo of Plano, we believe care shines brightest when tailored with heart. Our dedicated caregivers offer thoughtful, individualized support—from daily routine assistance to heartfelt companionship and personalized...
Our path is simple- to make a difference to our clients while helping them achieve their best selves, providing best possible individualized care from people who truly care. We understand life has lots of journeys and...
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...
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SHALOM HOME HEALTH SERVICES is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Century Home Healthcare Services LLC is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Passionate Care Home Health Services Inc is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The senior care services of Caring Senior Service are tailored to meet your personal needs. You will receive one-on-one care from a professionally trained caregiver that understands your needs and that will provide care...
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Peace Home Health Inc is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Multicare Nurses is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hammond knew one thing from the past that would be vital for success – people. High quality, high character, passionate would be our greatest resource. Every decision would start with the question, first who, then what”....
EHCS is dedicated to becoming a servant leader in the home care industry. We exist to enhance the quality of life for our clients and to promote independence and healing in the comforts of their home. Book an appointment...
Good Shepherd Home Healthcare Agency is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Visiting Angels of Richardson, TX is a home care provider that services in Richardson, TX. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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'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...
There is no higher priority to our NolasHands Family than the safety of our clients and caregivers. We aim to keep all of you out of harm's way and to support you through this challenging time.
When you or your loved one need help at home, turn to FirstLight Home Care. We offer complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just needs a little...
Keystone Healthcare, Inc. is a home health agency based in Richardson, Texas. It provides a variety of in-home health care services, including skilled nursing, physical therapy, occupational therapy, speech therapy,...
Senior Helpers of Richardson offers companion care, personal care, and chronic disease care to seniors in the Greater Dallas area. We help you to decide what care service is best for your loved one and family and...
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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.