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:
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...
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Home Instead - Irvine, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
President and CEO of Interim HealthCare of Irvine, Khushbu Dadlani, has spent the past 10 years caring for and educating preschool children. Faced with the challenges of caring for her own parents-in-law, Khushbu’s...
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Loved One Comfort Care stands out as a top provider of comprehensive home care solutions that aim to improve the quality of life for individuals across all age groups, especially our beloved elderly. Through a firm...
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Ativa Home Care - Newport Beach is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Senior Helpers of Costa Mesa is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Healthways Home Health Services, Inc is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Acti-Kare of Irvine is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Prime Assist Home Care is a company devoted to helping people who need care and companionship. We provide a wide variety of in-home care services which also include all activities of daily living such as grooming, bathing...
At Oasis Haven Hospice, we understand the importance of a multi-disciplinary, team-oriented approach in order to provide you with the highest quality of comfort care and the best experience possible. Our team incorporates...
LivHOME Orange County is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We’re a family-owned franchise boutique located in the heart of Orange County. We believe it’s time the in-home care experience became more personalized, positive, and powerful. We bring our own family’s experience as...
Absolute Health Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Stat Home Care serves clients in Southern California with quality home care services. Our primary purpose is to make life easier for individuals who are in need of constant supervision and assistance. With our services,...
Cerna HomeCare - LA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Home Personal Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
American Homecare, Inc provides premier care for seniors in the comfort and familiarity of their own homes. American Homecare caregivers provide assistance with daily activities of living such as bathing, cooking,...
Comfort Keepers of Irvine, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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ElderCare Anywhere is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
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At Arosa, we believe in keeping the entire trust circle actively involved in care plan development so we can all make informed choices that are truly in the client’s best interests. Contact us today to learn more about...
AllCare Homecare provides compassionate and personalized in-home care services to seniors and individuals requiring supported living services. We prioritize our clients' independence and dignity, and our goal is to help...
Home Helpers In-Home Care Services 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, and we...
Prime Care Quality Home Care is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OPTIMAL SENIOR CARE SOLUTIONS is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Operated by a married couple that holds a Bachelor of Science in Nursing degree. Having the passion to significantly improve the lives of the people by serving them in a S.M.A.R.T. way and consistently implementing the...
Seniors Helping Seniors - Orange County, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
TheKey Corporate - Orange County, CA is a home care provider that services in Irvine, CA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
KIND CARE is an In-Home service provider, which assists individuals to lead dignified and independent lifestyles in the comfort and safety of their own homes. We are a business designed to provide a unique all-in-one...
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...
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...
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...
Acti- Kare of Irvine provides senior care and home care services in the following locations including Irvine, Newport Beach, University Park, and Northwood in California.
Acti-Kare of Irvine provides quality in home care services to families and seniors in Irvine, Foothill Ranch, Trabuco Canyon, Rancho Santa Margarita, Las Flores, Coto De Caza, Costa Mesa, Fountain Valley, Huntington...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We our licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Golden Age Companions is dedicated to improving the lives of seniors and others who have reached the point in life where they need companion care. We’re dedicated to providing personable, hands-on, and integrated caring...
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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.