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:
Caring Companions, LLC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ameriCARE Fayetteville’s in-home CARE offers personalized care plans that emphasize helping our clients maintain their dignity and self-respect while providing peace of mind, companionship, safety, and supervision as...
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...
Licensed for Hands on Care and Companion Services Fully Insured Licensed by the Department of Health and Human Services Division of Health Services Regulation Covering 14 counties out the Raleigh office: Wake, Alamance,...
Visiting Angels - Fayetteville, NC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
T & C Robinson, Inc. is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amedisys Home Health of Fayetteville is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
S&K HomeCare is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cornerstone Caregiving stands apart in offering compassionate, authentic assistance for your loved ones. We are senior care professionals with 20+ years of experience in the caregiving field who are willing and ready to...
Lily Health Care is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our team of highly trained professionals deliver a wide range of specialized home care services to patients who wish to maintain their independence at home. We facilitate home healthcare in a safe, familiar and...
Clear Care Home Care - Fayetteville, NC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a dedicated healthcare provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity.
Care That Comes to You. Caregivers You Can Trust. Feel better in the comfort of your own home. We specialize in care and daily living assistance to an array of individuals. Whether you need daily or weekly assistance...
Basic Home Care Agency, LLC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
B Unique Haynes Home Care, Inc. is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At One to One Home Care Agency, our mission is to enhance the quality of life for our clients through compassionate, personalized home care services. We are dedicated to providing exceptional, individualized care that...
Have you ever just wanted to be treated like Royalty? If so, Royally Home Health LLC is here for you. Our care is extraordinary and you will be treated like Royalty. Royally Home Health LLC was established February...
Seniors Helping Seniors Sandhills NC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Assertive Home Care Services, Inc. is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Golden Years Outreach Services is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Christian Faith, we understand you want top quality senior home care services for your loved one. You are searching for a qualified, professional elder care provider who will treat your family member with compassion,...
Bridge to Care Homecare, LLC is a premier non-medical home care agency dedicated to providing compassionate and personalized care to seniors and individuals with disabilities in Fayetteville, NC. Our mission is to enhance...
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,...
We are dedicated to providing quality paraprofessional services so our highly value aged and disabled clients can achieve the highest level of independence and independence of life in the comfort of their own home.
Healthkeeperz is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Brighter Future Home Healthcare, we provide a wide range of home health care services to patients all throughout the North Carolina area. Our staff goes above and beyond to make sure you get the best quality care...
Comfort Keepers provides award-winning in-home care for seniors and other adults in need of assistance with daily activities. Our highly trained and dedicated caregivers can help your loved one stay in their home for as...
Homewell Care Services of Fayetteville, NC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care Starts at Home, LLC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Fogodemisa Home Care, LLC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Changing Lives Home Care, LLC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Native Angels Home Care Agency is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Avid Health at Home of NC is a home care provider that services in Fayetteville, NC. 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,...
Lor-Raine Home Care is a family owned business established by Tijuana White in 2020 in honor of her late mother, Lorraine Thompson. Tijuana has 30 years of experience in the medical field. She began her career as a...
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...
Within Your Doors Home Care, Inc. is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Myles Home Health Agency, Inc. - Fayetteville, NC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Healthy Hands Home Care Agency is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Caring Hand Home Care, based in Fayetteville, NC, provides exceptional non-medical in-home care to surrounding areas. Our mission is to enhance clients' quality of life through compassionate, personalized care, ensuring...
When you choose Eternal Love and Gracious Hands Home Care as your care provider, you choose a compassionate company that puts your needs first. We provide personalized services based on the level of care you or your...
Our vision at Ultimate Dream Care Services Inc. is to be the leading provider of home care services in North Carolina, recognized for our unwavering commitment to excellence and compassion. We envision a future where...
Amazing Home Care Agency, LLC is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cape Fear Val Med Cent is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Native Angels Home Health, Inc is a home care provider that services in Fayetteville, NC. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The Godwin family opened the Senior Helpers Dunn office in 2010 to deliver the best possible in-home care to seniors in the Dunn community. Whether an aging loved one needs companionship, personal care or assistance with...
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.