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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:
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Home Helpers Home Care of Orange Coast is more than an in-home health care agency – we’re your extended family when family can’t be there. We’re a locally owned, trusted provider of quality, compassionate in-home care in...
Totus Tuus Solutions is a premier non-medical home care agency located in the serene city of Yorba Linda, California. With a commitment to providing compassionate and personalized care, we specialize in offering a range...
Our core mission is to provide the best personal care to our clients. We focus exclusively on personal care, assisting our patients in facing their daily challenges and undertaking their tasks comfortably. We help people...
Ativa Home Care - Newport Beach is a home care provider that services in Costa Mesa, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sunset Healthcare Inc. is a company that specializes in providing a wide range of healthcare products and services, with a focus on respiratory and home medical equipment.
Home Instead - Irvine, CA is a home care provider that services in Costa Mesa, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Senior Care is the leading in home senior care provider in California, specializing in Alzheimer's & Dementia Care. It is an established and respected senior care provider offering senior home care, personal...
Premier Home Care is your family's trusted companion and the leader in providing affordable personal in-home quality care solutions and services for seniors and disabled individuals. Services can be provided 24 hours a...
At PCS, we are dedicated to providing compassionate and professional care for you or your loved ones. Our team is extensively trained and committed to enhancing the quality of life of clients by delivering personalized...
Est 2008, Caregiver Provider in California. We provides in-home senior care, helping older adults continue to live well and independently at home and anywhere.
If you are currently caring for a loved one that is having challenges living independently, we understand how difficult it can be. With the right kind of help, it’s possible to improve their quality of life so they can...
Home Care Services in Newport Beach Reliable, Experienced Elderly Care Newport Beach families know the secret to quality in-home care is compassion. At Homewatch CareGivers of Huntington Newport Beach, we treat your...
Our goal at Harmony Home Care is to work together with clients and families to provide the highest quality home care possible, enabling clients and their families a more secure and fulfilling domestic life. We furnish...
TL Caregiving is a home care provider that services in Costa Mesa, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ASSURED INHOME CARE ORANGE COUNTY is a home care provider that services in Costa Mesa, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kindness Care Home Health is a home care provider that services in Costa Mesa, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All Valley Home Care is a home care provider that services in Costa Mesa, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
We provide compassionate, competent caregiving for you and your loved ones in the privacy of your own home. Our professionally trained Health Care Providers each have clearly identified responsibilities and qualifications...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
Sea Crest Home Health Services Inc is a home care provider that services in Costa Mesa, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We know it isn't easy to make the decision to invite a stranger into the home to provide care for loved ones who can no longer be safely left alone. That’s why our mission at Visiting Angels is to provide the highest...
Why worry? LET US HELP... because WE CARE! Responsible, Professional, Affordable, Reasonable, and Dependable. Our Caregivers/CNAs provide everything from companionship to Full Service. In-home, In-facility,...
Real Help Home Care is a home care provider that services in Costa Mesa, CA. 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...
When you or your loved one need help at home, turn to FirstLight Home Care of Irvine. We offer complete companion and personal care services for seniors, new mothers, those recovering from surgery, or anyone who just...
At Tandem Careplanning, our mission is to revolutionize home care by empowering seniors and uplifting caregivers, ensuring that together, we thrive. Our CEO, Joshua Greer, faced the same challenges and frustrations as...
Tremendous Care is a family and Hoag physician founded home care agency based in Orange County, CA. We are committed to delivering compassionate, specialized care that meets the unique needs of each individual we serve....
Since 2005, Living Well Home Care has been providing one-on-one care throughout Southern California (specifically Los Angeles and Orange County). We are a proud California Licensed Home Care Organization (HCO) committed...
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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.