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'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...
More than 90% of seniors want to age in their own home with dignity but getting the right type of care can seem daunting. At Senior Helpers Denver North we believe getting the best care for your loved ones should not be...
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Seniors Helping Seniors® in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing...
Our in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing compassionate care in the...
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 are a senior home care service that allows your loved ones to stay where they feel most comfortable: at their home in the Mile-high City or in surrounding areas.
ACASA Senior Care - Denver, CO is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With over 40 years of serving our local community, Homewatch CareGivers is the oldest in-home care company in the world. We were founded in Boulder Colorado in 1980.
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Assisting Hands Home Care of Littleton, CO is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Senior Helpers - Littleton, CO is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Wright Nurturing Care & Associates is committed to keeping our Clients in the comfort of their homes by providing the highest level of home-based, personalized services, encouraging client independence, and offering an...
IN-HOME CARE FOR SENIORS, THOSE WITH DISABILITES, ILLNESS OR RECOVERING FROM INJURY OR SURGERY Home Helpers® Home Care is a in-home care service that provides top quality in-home care. Our Cared-4℠ program is a holistic...
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.
At Amada Senior Care Westminster, our personal and professional experience has shown us that there is no “one size fits all” approach to providing high quality senior care.
Welcome to SYNERGY HomeCare! We truly appreciate the opportunity to help you. We are proud to announce that our Synergy Home Care Broomfield office has been awarded the 2016 Best of Home Care® Provider of Choice Award*...
Acaria Inc is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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When you or your loved one need help at home, turn to FirstLight Home Care in Denver West. We offer non-medical in-home care, complete companion, and personal care services for seniors, new mothers, those recovering from...
First Tender Loving Care, also known as First TLC, is a Home Healthcare service provider for minors, seniors, and elders. We ensure the best quality care services for our clients by our team of trained Professionals to...
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Assisting Hands exemplifies compassion, dependability and dignity to all of our clients. Our company was founded on the principles of caring for others in a way that we would also want to be cared for which is made...
Accent on Independence Inc is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Health In Home Nursing Services Inc is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Golden Harmony Home Health is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
BrightStar Care of Denver, CO is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Reliable Home Health Care Provider in Denver At A Daughter’s Love Home Healthcare, LLC, we're dedicated to upholding our profound mission, rooted in kindness, dignity, and empathetic quality. Much like the devoted care a...
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Angel Care PCP is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Personalized Senior Home Care Services in Littleton. Our services are tailored to meet your unique needs. We provide one-on-one care on your schedule. Regardless of the senior services you may require, we charge one flat,...
Visiting Angels - Brighton, CO is a home care provider that services in Denver, CO. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bayada Nurses Inc is a home care provider that services in Denver, CO. 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...
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...
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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.