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:
Here's a link from PA Notary. It says the Notary can get confirmation from a third party and describes how that is done. See Reason 2, starting page 4.
Hmm....I'm not sure why. Try googling Foolish Mistakes that Cost Notaries Money in PA. It should pop up. There's some glitch with the link. I'm not sure why.
REASON 5: Failure to identify the person whose signature is being notarized
It is the notary’s responsibility to properly identify the customer. This can be achieved by several methods: personal knowledge and satisfactory evidence. One notary in eastern Pennsylvania was fined $650 in civil penalties for failing to identify customers through personal knowledge or satisfactory evidence.
Foolish Mistakes That Cost Notaries Money Pennsylvania Association of Notaries PAN Report — Page 4 of 6
If the notary knows the customer as a friend, neighbor or relative with whom they’ve had shared experiences, then the notary’s personal knowledge of the customer serves as proper identification.
There are two types of satisfactory evidence defined by Pennsylvania Notary Public Law: acceptable identification and credible witness. Acceptable identification is a current, government-issued identification card that includes a photograph, signature or physical description, and a serial or identification number. Government-issued identification cards include current drivers’ licenses, passports, permanent residence (green cards) and identification cards issued to government employees.
If a customer does not have acceptable identification, the notary can rely on the testimony of a third person known as a credible witness. A credible witness must be personally known to the notary, must personally know the customer and must appear before the notary with the customer present. The notary must administer an oath or affirmation to the credible witness who then swears to or affirms to the identity of the customer.
A notary had her commission suspended for six months, was fined $650 and ordered to attend a notary education course because she failed to personally identify her customers.
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.
file:///C:/Users/Debby/Downloads/Foolish%20Mistakes%20the%20Cost%20Notaries%20Money.pdf
REASON 5: Failure to identify the person whose signature is being
notarized
It is the notary’s responsibility to properly identify the customer. This can be
achieved by several methods: personal knowledge and satisfactory evidence. One notary in eastern Pennsylvania was fined $650 in civil penalties for
failing to identify customers through personal knowledge or satisfactory
evidence.
Foolish Mistakes That Cost Notaries Money
Pennsylvania Association of Notaries PAN Report — Page 4 of 6
If the notary knows the customer as a friend, neighbor or relative with whom
they’ve had shared experiences, then the notary’s personal knowledge of the
customer serves as proper identification.
There are two types of satisfactory evidence defined by Pennsylvania Notary
Public Law: acceptable identification and credible witness.
Acceptable identification is a current, government-issued identification card
that includes a photograph, signature or physical description, and a serial
or identification number. Government-issued identification cards include
current drivers’ licenses, passports, permanent residence (green cards) and
identification cards issued to government employees.
If a customer does not have acceptable identification, the notary can rely
on the testimony of a third person known as a credible witness. A credible
witness must be personally known to the notary, must personally know the
customer and must appear before the notary with the customer present.
The notary must administer an oath or affirmation to the credible witness
who then swears to or affirms to the identity of the customer.
A notary had her commission suspended for six months, was fined
$650 and ordered to attend a notary education course because she
failed to personally identify her customers.