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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:
Always Best Care of Chester County has provided trusted non-medical in-home care for 15+ years. We combine national expertise with a local touch to help seniors stay safe and independent. Our caregivers focus on genuine...
One You Love Homecare Valley Forge was established to elevate senior care in our community through a locally owned and operated agency where relationships matter. Our owner personally connects with clients and their...
Formosity Support Services, LLC is a non-medical home health agency with over 10 years of experience providing compassionate and reliable care. They are dedicated to helping seniors and individuals with disabilities live...
Cornerstone Caregiving proudly serves Berwyn, the Main Line, and Chester County with compassionate, reliable, and personalized in-home care. Our mission is to help seniors and individuals maintain independence, dignity,...
Home Instead - West Chester, PA is a home care provider that services in Exton, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When you and a loved one in your life require care assistance, Executive Home Care is ready to lend a hand. Find out more about the expert and compassionate senior living care that is offered in the comfort of one’s own...
Reliable Homecare Angels is a home care provider that services in Exton, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Vital Guardian Healthcare LLC is a home care agency based in Gilbertsville Pennsylvania that provides in-home support services designed to help adults remain safe comfortable and independent in their own homes. The agency...
As we age, we will eventually reach that point where we only have little control over our mobility, our health and many other life circumstances that are tied with old age. Similarly, we experience these struggles when we...
At BrightStar Care Greater Chester County, we believe that caring is more than just a job– it’s a way of life. That’s why our caregivers mean so much more to the people, families, and organizations they serve. BrightStar...
At Amada Chester County, we strive to provide the highest quality of care with a sense of warmth, kindness and compassion. Each member of our team is committed to your loved one because to us, they are family. We take...
Maxim Healthcare Services Inc is a home care provider that services in Exton, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We provide compassionate elderly care that guarantees peace of mind. Rest assured that our caregivers have been duly screened and trained to provide professional homecare to seniors.
Relative Health LLC is a home care provider that services in Exton, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Full Range Home health is a home care provider that services in Exton, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
Our dedicated staff is composed of skilled, well-trained, and experienced caregivers who are experts in providing non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or...
Touching Hearts at Home was founded by Renae Peterson, who began providing professional caregiving services to seniors, older adults, and those in need in 1996. Integrity, empathy, and the belief in the dignity of all...
Success Home Care is a home care provider that services in Exton, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Services are available around the clock, 24 hours a day, seven days a week, including holidays. We can provide same-day home care, transition-of-care, such as transportation home after a discharge, or assist with many...
If you’re seeking care services for your aging or differently-abled loved one, Home Helpers® Home Care offers a better, more affordable alternative to nursing homes and assisted living facilities. We are a provider of...
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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.