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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:
Right at Home helps seniors and disabled adults remain in the comfort of their own home. If you or a family member needs assistance with routine daily activities, Right at Home is the helping hand you seek.
Home Matters of Philadelphia-- Montgomery County is a home care provider that services in Glenside, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Different Care Home Care LLC is a home care company based in Philadelphia, PA, specializing in providing non-skilled in-home care services. Their offerings cater to individuals who need assistance with daily living...
Senior Helpers - Havertown, PA is a home care provider that services in Glenside, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our founder Quiera Dover watched many patients, seniors, and clients with intellectual disabilities fight to gain independence and decline in their ability to do for themselves. Quiera found that most seniors want to be...
The Right Touch, Inc. is an in-home care company dedicated to providing compassionate, personalized care to individuals in their own homes. Offering non-medical services such as assistance with daily activities,...
The Mission of the Health Angels Home Health Services LLC is to enable patients under our care to live independently and retain a sense of freedom of choice as they age. Our specialists work closely with the patient,...
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 are committed to providing services focused on care that is reliable, compassionate, and courteous to our clients. It is our priority to assist our clients in living their lives with dignity in the comfort of their own...
Allegiant Home Healthcare is a family owned and operated non-medical home care company. We have a combined 35 years of experience in the home and health care industry. Our experience, expertise and loyalty to the...
UNIQUELY PREPARED TO DELIVER excellent home care Affinity HealthCare Solutions stands apart as a home care agency that is uniquely prepared to provide trustworthy personal assistance to individuals and families with a...
Neighborly Home Care - Ardmore is a home care provider that services in Glenside, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Unity Love Home Healthcare LLC is a home care provider that services in Glenside, PA. 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...
Amada Senior Care of Bucks and Montgomery County, PA is a home care provider that services in Glenside, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Adored by Me Home Healthcare Agency believes that homecare should be offered and made available to everyone who is in need of medical attention. Getting access to homecare should not be limited to select individuals but...
Age in Place - Philadelphia/Montgomery Region is a home care provider that services in Glenside, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Tata Homecare Services LLC is a home care provider serving Montgomery and Bucks County, offering a range of services that allow seniors to safely remain in their homes while receiving essential care.
AM PM Home Care Services is a home care provider that services in Glenside, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Citadel Home Care is the leading Home Care agency across Pennsylvania and New Jersey. We provide peace of mind to families knowing the most important people in their life are in the care of the most dedicated professionals.
Keystone Home Health Services is a home care provider that services in Glenside, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With Brightview Home Healthcare, you will receive quality, trustworthy care from one of our professional Certified Nursing Assistants, Home Health Aides, or Personal Care Attendants. From assistance with dressing,...
Human Connection Home Care is a home care provider that services in Glenside, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kingsway Homecare Agency takes pride in offering one to one patient-centered non-medical home care services for every stage of life by focusing on what matters most to our clients and their families.
Faithful Home Care Solutions LLC is a home care provider that services in Glenside, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Tradition of Homecare Excellence Griswold Home Care is a non-medical homecare company. We refer Caregivers who provide personal care, homemaking, meal preparation, companionship, incidental transportation and other...
At BrightStar® Care of Lower Bucks and Southeast Montgomery Counties, we strive to deliver just the right care for your loved one to be safe and healthy and to be a partner you can turn to for support. BrightStar 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.