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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:
PROVIDING CARE BEYOND COMPARE ALMOND HOMECARE LLC is a dedicated and compassionate organization that aims to provide exceptional and quality in-home care services for the elderly.
We are committed to providing high quality, client-centered and affordable Home Care services to our clients to assist them to lead dignified and independent lives in the comfort and safety of their own homes. Their...
GYC Senior Care Services is a home care provider that services in Barrington, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Whether you need Senior Helpers' assistance 24/7 or just a few hours a day, our offices are here to help with flexible service options. We provide professional and compassionate in-home care so that our seniors can age...
LOVING ATTENTIVE HOME CARE is a family-owned, established company dedicated to the care of families in the Chicagoland area. We are a bonded and licensed health care provider.
Our Goal The main goal of Gifted Hands Home Care Agency LLC is to bring smiles to the faces of our patients and their families. Our home care services target a wide range of people – from young adults, and veterans, to...
At Homewatch CareGivers of Libertyville, we understand the importance of maintaining independence and comfort in your home. We are committed to providing compassionate and professional in-home care services tailored to...
Optimum Senior Care Optimum Senior Care offers in home senior care and caregiver services to the elderly population in the Chicago Metro area. Our mission is to cherish and protect the independence and dignity of our...
DUPE OLD ACCOUNT SYNERGY HomeCare of Barrington, IL is a home care provider that services in Barrington, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
The Beginning Home Care is not only our name, but it stands as our way of service. We bring safe, loving, and caring services to those that desire to have a nursing home setting and treatment, in the comfort of their own...
Hal and Lenore Baker understand the challenges associated with caring for aging and ailing loved ones, including firsthand experience managing extended care for their own parents. They founded Senior Helpers of Barrington...
At ACASA Senior Care, we understand the desire that people have to stay in their homes – all while receiving superb care. So, we work hard to provide that service. Our in-home care services give our clients in Chicago’s...
In 2019 Susie Murphy started D’Vine Caregivers as a natural extension of her 35 years of excellence in matching nannies and domestic helpers with young families. She now brings her skills and insight in finding and...
Acti-Kare of Barrington, IL provides tier one in-home Personal care. Our trained, insured, and bonded caregivers will provide your loved one with in-home personal care services across a broad range of categories. As we...
Harmony Home Care is a home care provider that services in Barrington, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentle Guardian Care - Helping people stay at home and independent longer through compassionate, trusted caregiver services. Home-Based Care Options For The Aging, Disabled or Chronically Ill: Based out of locations in...
Ease In The Home Care of North Barrington, IL is a home care provider that services in Barrington, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Jo Home Care Services, our mission is to empower individuals to live their best lives in the comfort of their own homes. Together, we can make a difference in the lives of seniors, individuals with disabilities, and...
Amada Senior Care of Barrington, IL is a home care provider that services in Barrington, IL. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
North Shore Compassionate Care is the ideal solution for elderly or disabled individuals who want to maintain their independence and dignity by continuing to live in the comfort of their own homes. Our home health...
Diego Uribe has owned and operated SYNERGY HomeCare of Barrington since 1986, serving the greater Barrington area and the surrounding suburbs, including Algonquin, Buffalo Grove, Huntley, Inverness, and Lake Zurich....
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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.