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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:
We at FirstLight Home Care exist to help people have their best day, every day. Our mission is to provide compassionate home care so that the families we serve have peace of mind knowing their loved ones are receiving the...
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...
Thrive Home Care - San Leandro is a home care provider that services in San Leandro, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Golden Hope Services is a reputable home care agency dedicated to providing compassionate, personalized in-home care services for seniors and individuals with disabilities.
Liora Senior Care is dedicated to providing exceptional in-home, non-medical support that truly goes above and beyond expectations. With a deep passion for helping seniors maintain their independence and dignity, our team...
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...
Nurse Next Door - Santa Clara, CA is a home care provider that services over 40+ zip codes across Santa Clara County. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Assisting Hands of Fremont CA is a home care provider based in Newark, CA and serves Alameda County. Whether it’s help with daily activities, personal care, safety concerns due to cognitive decline, or the desire to...
Our home care services can help aging adults stay engaged in everyday life with tailor-made support by professional caregivers to stay safe and well at home. It’s our mission to provide a care plan personalized to your...
Senior care matters deeply here in the East Bay Area, where our senior population continues to grow and become more diverse. It's all about improving the lives of our older community members, ensuring their safety, and...
Key Rose Home Care began with a simple yet powerful idea: care should be available when and where it's needed. We understand that aging, recovery, or living with a health condition shouldn't mean sacrificing independence...
Home care is a service that you can rely on when you need assistance in the comfort of your home. If you are struggling with old age, injury, or illness, this might be the right time for you to look for a caregiver who...
Care Indeed provides non-medical home care services to seniors: personal care, support with mobility, help with household chores, companionship, and transportation. We also send our trained and experienced caregivers,...
We support people to do the extraordinary everyday. ReachPoint Home Care is a local provider of home care and staffing services with over 10 years of experience and dedication to enhancing quality of life for...
A1 Home Care LLC provides compassionate, personalized in-home care designed to help seniors and adults remain safe, comfortable, and independent at home. Services may include personal care, companionship, meal...
Best Living Care LLC of Alameda, CA is a home care provider that services in San Leandro, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Seniors Helping Seniors - Upper East Bay, CA is a home care provider that services in San Leandro, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our experienced caregivers are here to make life easier for your family, providing everything from assistance with daily activities to non-skilled medication in the comfort of your own home—using modern technology and...
Nightingale Nursing is a home care provider that services in San Leandro, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Human kindness and total peace of mind is what Thrive Home Care strives to serve to our clients in San Mateo County and all over the Bay Area! Having a caregiver in your loved one’s home is an important decision, a...
Thrive Home Care provides non-medical home care to seniors and individuals who need an extra hand at home in Santa Clara County. Our caregiving services ranges from hourly care to extended hourly shift care that is...
First Call Care Partners is a home care provider that services in San Leandro, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Key Rose Home Care began with a simple yet powerful idea: care should be available when and where it's needed. We understand that aging, recovery, or living with a health condition shouldn't mean sacrificing independence...
Thrive Home Care now serves the 7×7 city and county of San Francisco. We provide hourly and extended shifts with rates that are affordable and reasonable. Thrive Home Care is dedicated to serve and offer the best quality,...
Larry Tonti opened Senior Helpers of San Leandro – Alameda in 2018. He has witnessed firsthand how difficult it is for seniors and family caregivers to find quality in-home care services when they need them most. As a...
A & M FAMILY HOME CARE AGENCY INC. is a home care provider that services in San Leandro, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
There is an incredible demand in our society for care professionals, and we are proud to be up to the task. And it's not just for seniors — if a member of your family needs help, we're the place to call. As we are a...
At Home Helpers Home Care of Fremont & Union City, our primary goal is to deliver trusted and affordable in-home care solutions that will keep your loved one happy at home. We take great pride in providing expert care...
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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.