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:
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RA Quality Home Care LLC is a trusted Pennsylvania home care agency dedicated to improving the quality of life for seniors and individuals who need assistance with daily living activities.
An Amazing Personal Care Corp. is a provider of home care in Pittsburgh, Pennsylvania, devoted to furnishing amazing solutions that meet the unique demands of ever-changing home care needs. Every caregiver in our team is...
Ensurcare LLC is a home care provider that services Monroeville, PA 15146. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and other daily...
We are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in Oakdale or in surrounding areas like Bloomfield, or North Shore. Our trusted Pittsburgh staff...
Senior Helpers of Northwest Pittsburgh is proudly owned by husband-and-wife team Chris and Nicole Wasel. After witnessing the emotional and physical toll caregiving placed on their own family—watching their parents care...
Green Oaks Home Health Care, LLC is a home care provider that services Pittsburgh, PA 15213. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal...
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...
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24/7 BrightStar of Pittsburgh, PA is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Alston Home Care Solutions, we provide reliable and affordable home care services to clients in the Allegheny county and surrounding areas. Whether you need daily health related attention or are looking for appointment...
Candid Homecare of Pittsburgh, PA is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A&B'S EXTENDED FAMILY HOME CARE, LLC. is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
365 Health Services, LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Ace of Hearts Home Care LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BRIDGE CITY HOME CARE LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Hand From Above provides compassionate and personalized in-home care services for seniors and individuals with disabilities. Our dedicated caregivers assist with daily activities, personal care, and companionship,...
Bano's Quality Home Care Inc. is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Local Home Care Experts Here to Serve You Anna’s guardian angel homecare agency,LLC is the most reliable Home Care Agency in the Pittsburgh area . Our practitioners provide the best home care services and cater to the...
Allegheny Home Care is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our support service and companionship packages are individually tailored to meet the needs of your LOVED one, while focusing on maintaining their independence.
Whether you or your loved one needs home health, hospice, palliative care or personal care, we have high-quality programs to meet your needs through our continuum of care. We ensure you receive the right care at the right...
Annin Care Home Care LLC is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of North Hills / Pittsburgh, PA is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aseracare Home Health is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Candid Home Care is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Always at Home is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Moving from the hospital back to your home is nothing to be taken lightly. Similarly, your transition in to your senior years is not something that comes as a smooth and easy experience for everyone. At Active Living Home...
Bayada Nurses Pittsburgh is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angels Of Care By TLM LLC is a licensed insured and bonded Home Care agency based in Pennsylvania. We provide 24-hour care including live-in services, that provides one day service up to 24 hours a day, short-term and...
BEYOND HOME HEALTH CARE, LLC. is a home care provider that services in Pittsburgh, PA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Caring Hand Home Care, Inc. does not discriminate against any person on the basis of race, color, religion, disability, or age in admission, participation, or receipt of the services & benefits under any of its...
Acta Care, LLC is a home care provider that services in Pittsburgh, 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...
Acti-Kare is a leading in-home senior care company that has been trusted for over a decade. Our caregivers are insured, bonded, and trained which means you will receive a trusted and professional caregiver every time....
Apple Caregiving Agency LLC is a dedicated provider of personalized in-home care services, focusing on enhancing the well-being and quality of life for individuals in need of care.
Jeff Kosor opened the Senior Helpers of Southwest Pittsburgh office to provide dependable, affordable in-home care to seniors throughout Southwest Pittsburgh community. Senior helpers creates a comprehensive at-home plan...
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.