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.
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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:
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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...
DignityFirst Health at Home Where genuine expertise, integrity, and compassion come together to preserve and enhance our clients’ quality of life, safety, comfort, dignity, and maximum independence.
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Home Health Care – Denver West -Hello from Lakewood, Colorado! We are Susie Fogerson and Shanna Tourtlotte, owners of SYNERGY HomeCare of West Denver. Together we bring nearly 10 years of home care experience to the...
At HomeWell Care Services, we provide live-in and hourly at-home care for seniors, the elderly and others who are struggling to manage day-to-day activities like grooming, bathing, cooking, or even running errands. Our...
Adriana is a dedicated human service professional with roots in Colorado’s diverse communities. After caring for her mother, she entered the field of human services and has worked to serve underprivileged groups. She’s...
Cornerstone Caregiving combines home care with a personal touch, ensuring that your love ones are treated with respect and compassion. Our team of skilled caregivers and supportive office staff provides empathetic,...
Touching Hearts at Home care can be provided for just a few hours per visit, up to 24 hours, 7 days a week. YES, this includes weekends and holidays. Be it a medical condition, disability, or the gradual changes that come...
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Our Mission : To Provide Seniors with high quality, reliable, and trusted home care services in the comfort of their home while promoting A Peace of Mind to their Family and Friends. Personal In-Home Care for Seniors...
Best Care, Inc is a locally owned and operated skilled and non-skilled home healthcare agency. Founded by a registered nurse, Best Care has served the Denver metro area since 1995. As a skilled and non-skilled agency,...
TheKey of Greenwood Village, CO is a home care provider that services in Englewood, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We build caregiving teams to improve people’s lives wherever needed. We are Interim HealthCare of Denver. Interim HealthCare of Denver is a premier organization committed to providing quality health care to the people...
Providing Comfort and Service in Your Home •   A tailor-made program to serve  you in your home from a few visits per week to 24-hour services •  Light housekeeping, laundry, meal...
Homewatch CareGivers of Englewood, CO is a home care provider that services in Englewood, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Physicians Home Health Care is a home care provider that services in Englewood, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring Senior Service of Littleton, CO is a home care provider that services in Englewood, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Since 1975, Bayada Nurses has helped people have a safe home life with comfort, independence, and dignity. Bayada Nurses provides skilled, rehabilitative, therapeutic, and personal home health care services to children,...
All State Home Health is a home care provider that services in Englewood, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Through innovation, education, genuine compassion and uncompromising values, GoldLeaf Home Health Care is revolutionizing the home care industry to provide greater individual independence and quality of life at all ages.
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Our team makes loved ones feel confident and dignified while allowing them to maintain their independence. We provide personal care services, which allows you to spend more quality time together. ACASA Colorado...
Home Health Care Professionals Inc is a home care provider that services in Englewood, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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A Place At Home co-owner Alex Claudill served ten years in the United States Marine Corps, both active duty and in the reserves, where he trained and led Marines as a Sergeant. Since then, he has held several leadership...
HomewatchCaregivers of SW Denver is a home care provider that services in Englewood, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At AmeriCARE Denver we believe that all people deserve to live and thrive in the comfort of their own homes, wherever they call home. We understand the complications that come with aging, surgery recovery, and managing...
You have Choices. Let Homewatch CareGivers help you explore the alternatives that will preserve your independence and freedom to live your life safely and comfortably at home. Homewatch CareGivers’ quality in-home care,...
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TheKey Corporate- Centennial, CO is a home care provider that services in Englewood, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The Stay at Home Solution Select Home Care is an experienced, dedicated and caring organization. Our services are for older adults and impaired individuals who need extended care. As an alternative to long term...
We are the right people, doing the right things, the right way, for the right reason. When you choose us to provide in-home care for your loved one, you can feel confident they will receive the right care. Our senior Care...
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...
Assisting Hands provides professional in-home health care services allowing our clients to remain safely and comfortably in their own homes. At Assisting Hands Home Care, we understand. Our trained dependable...
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.