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:
We’re always there when you need us – ready to provide care in all ways. When faced with the decision to provide care, you need a trusted partner. One who has the knowledge gained from years of providing quality home care...
At Amada Senior Care of Greater Indianapolis, our goal is to walk with seniors and their loved ones through every step of their senior care journey. They are committed to preserving dignity and giving families the peace...
Assisted Loved Ones LLC is a home care provider that services in Indianapolis, IN. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Prestige Loving Home Care, we are committed to delivering exceptional service to your loved ones. With a dedication to personalized care, we ensure every client experiences comfort and peace in their home and lives an...
Of Excellence and Love LLC is a distinguished provider of compassionate and personalized home care services, committed to enhancing the lives of individuals who require support with daily living activities while...
ComForcare Home Care is a non-medical home care agency located in Carmel, Indiana providing services in clients' homes and various facilities. No services are provided at the office.
When you have an aging family member in Greenwood, IN who may benefit from senior care, Senior Helpers Greenwood is here to help. At Senior Helpers of Greenwood, we offer comprehensive care, and can tailor a package that...
Saved By Grace Home Care LLC is a leading provider of personalized home care services, offering compassionate assistance and support to individuals in the comfort of their own homes. Rooted in the values of empathy,...
Our mission is to provide you with the finest quality in non-medical in-home support and care. We strive to serve the people in our communities by affirming life and the dignity of our patients with a variety of services....
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...
Our talented staff is here to assist you and your loved ones. We have experienced nurses who have the ability to work with all patients no matter their expected needs. Based in Indianapolis, IN, we service 80% of the...
Welcome to Reason To Love Home Care Agency LLC, your go-to home care services provider in Indianapolis who are looking for comfort and peace of mind. We provide a range of services tailored to meet the specific needs of...
Golden Heart Senior Care offers the highest quality companion care, home care services and personal care services so our clients can live a full and independent life in the comfort of their home.
Believers Home Care LLC is a home care agency dedicated to providing high-quality, personalized care services to individuals who need assistance with daily living activities.
Arbor Village Services LLC is a dedicated home care agency specializing in providing high-quality, personalized care services to individuals in the comfort of their own homes.
Luxury Care At Home LLC is a premium in-home care service provider specializing in offering personalized, high-quality care for seniors and individuals requiring assistance with daily living activities.
Renee’s Helping Hands is a home care and companionship service provider based in Indianapolis, Indiana. We have more than 21 years of collective experience, providing loving and genuine care to people who need assistance...
At Orange Home Care Services, our mission is to provide compassionate, personalized care that enhances the quality of life for our clients. We are dedicated to supporting individuals and their families by offering...
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...
Highland Community Bridge offers personalized in-home care services for seniors and individuals with disabilities. Our compassionate caregivers provide assistance with daily tasks, medical support, and companionship,...
Established in 2021, MAGNIFICENT HOMECARE LLC pays homage to the owner’s late sister, who courageously battled SMA and required constant in-home care. Her enduring journey profoundly inspired the core mission of our...
We’re here to help you continue living independently. If you or a loved one is having trouble with activities of daily living, home safety or personal care, we can provide a personalized care plan to make life easier and...
At TMC Homecare, LLC, our mission is to deliver exceptional, compassionate homecare services that promote the health, independence, and dignity of our clients.
At Dependable Living, we are committed to empowering individuals to lead vibrant, secure, and fulfilling lives. Our mission is to provide unparalleled support and resources that enable our clients to navigate the...
We Make A Difference In Senior Lives At Happy Homes Homecare, we are dedicated to providing exceptional in-home care for seniors. Our mission is to ensure that every senior receives the care, respect, and companionship...
Here at Quality comfort we provide personal care, such as getting in and out of bed, walking, bathing, and dressing. We offer personal care services can provide aides that also help remind you to take your medicines, do...
TopCare Home Care is dedicated to providing compassionate and personalized in-home care services that support individuals in maintaining their independence and quality of life in the comfort of their own homes. With a...
Infinite Loving Hands is a Licensed provider of the State of Indiana certified to accept Medicaid Waiver services Statewide. Infinite Loving Hands is BBB-certified with an A- rating and five-star reviews on Google.
Dellavenias Home Care LLC is a dedicated provider of non-medical home care services, committed to enhancing the quality of life for seniors, individuals with disabilities, and those recovering from illness or surgery. Our...
We are a Personal Care Agency that provides personal home services to the rapidly growing retirement community. We are dedicated to providing our clients with high-quality care and assistance, so they can live comfortably...
Our Mission At Divinity Home Care, we tailor our care services to cater to the specific needs of our clients. We value each client's uniqueness and strive to assist them with assistance in their daily living. Let us help...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging; and our goal is to help our...
HomeWell is more than just a home care business; we are a community of passionate care management professionals and dedicated caregivers who believe in the power of care at home. Our team is comprised of kindhearted,...
At A Loving Hands Family Care LLC, we understand the importance of compassionate and personalized care for your family members. Our mission is to provide exceptional non-medical in-home care services to clients in...
HARMONY HAVEN is a locally owned and operated home care services in Indianapolis, Indiana founded by a dedicated Registered Nurse with a profound commitment to the well-being of our community. We provide assistance to a...
Care When and Where It’s Needed Our home care services are available 24 hours a day, 7 days a week, 365 days a year, so you know your loved one’s needs are always being met. We offer care when and where it’s needed,...
Senior Helpers Indianapolis helps families navigate the full continuum of senior care. Our in-home aides allow seniors to receive the day-to-day help with personal care they need and assistance with activities of daily...
CORNERSTONE CAREGIVING IN INDIANAPOLIS, INDIANA We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Indianapolis or in surrounding areas like...
Our team is dedicated to providing superior care with a focus on safety and respect. We understand how important it is to have confidence in the care your loved one is receiving and we are here to provide that for you.
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'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 Love and Grace our mission is to bring compassion back into home care. It is our goal to foster companships and meaningful caregiver relationships, improving overall health for individuals. Our caregivers provide...
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.