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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:
I don't think were as spread around the country as one would imagine. I' saw 3 or 4 hoosiers here in the last week. I'll begin, I'm bob from MARTINSVILLE INDIANA..
I'm Eve, from Indio, CA (near Palm Springs). Been a tad hot here lately. Hit 122 yesterday. Got a cold snap coming though - going to all the way down to 108 by the 4th.
I'm Jen, I live in St. Louis, MO. Born and raised. Moved to Wichita with my husband and from there moved to Kansas City, MO but ended back up in St. Louis.
I'm Mary from a tiny place out in BFE near San Antonio, TX. It was 108 on Sat but a cold front came thru and dropped temps about 40 degrees. Yay! I was born in Denver, have lived in many places, but I call Texas home.
Bob - El Paso has a lot more humidity than we do. At least we can say, "...but it's a dry heat" lol. Like an oven. It runs about 9% during the heat of the day.
Igloo here...and I do not live in an igloo although I have a couple of Igloo coolers.... LMAO. New Orleans is home, 82 degrees today which is kinda nice and the not the usual "wet heat" of our summer.
Hey cap'n - I'm Massachusetts born and raised. Now living in central MA but I grew up in the "greater Boston area" so I consider myself a Bostonian as well. Wicked awesome thread...!
Hi All, Palm City Florida, five miles from the ocean and 30 north of Palm Beach. Expecting a really bad hurricane season this year but, right now, the beaches are beautiful.
id swap someone one tornado for a heat wave and a minor tsunami. as always ill toss in a used bike carb to sweeten the deal. an old hitachi, i aint gonna let go of a mikuni . im fair but not stupid..
Greetings from the left coast, the great liberal state of California. ( I feel like a delegate or a beauty contestant. I'll take world peace) We're in the OC, where the elite come to beat their feet on the streets of gold and taxes are never fully paid. I grew up in the Pasadena area, hubby is from Ellensberg, WA. He is country mouse, I am city mouse. Nice to meet you all:) xo
Lol! OHDIL! I love Texas the few times visited. My new SIL has family there and I like the "mentality." Yea, I'll bet that is one big state the Cap'n does not want to pass through. Tough place. Might as well come to CA, Bob. Haha! We like everyone here, and we're very understanding, due to border proximity:)
Ventura, California, on the east end. Hot here has been 90 degrees, the last two days, cooled to 84 today, but my husband has been laying asphalt in over 100 degrees up in Ojai! Ouch! Anybody close by?
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 was born in Denver, have lived in many places, but I call Texas home.
I grew up in the Pasadena area, hubby is from Ellensberg, WA. He is country mouse, I am city mouse. Nice to meet you all:) xo