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EverCare Lead Intake (Stage A)

Who are you searching for?

👧 Daughter or son

💑 Spouse or partner

🙋 Myself

📄 Someone I have POA for

🤝 Other family / friend

What kind of care fits best?

🏠 Adult Family Home

🏢 Assisted Living

🧠 Memory Care

💬 I'm not sure — help me

How soon do you need placement?

🚑 Within 48 hours (hospital discharge)

⏱ Within 1 week

📆 Within 1 month

🗺 Planning ahead (>1 month)

Cognitive and memory status

✅ No cognitive impairment

💭 Mild memory issues

🌀 Moderate dementia

🔒 Advanced — needs secured setting

Monthly budget (private-pay rate)

💵 Under $5,000 / mo

💵 $5,000 – $7,000

💵 $7,000 – $9,000

💵 Over $9,000

🏛 Medicaid (COPES) only

📑 Long-term care insurance

🎖 VA Aid & Attendance

❔ Not sure yet

ZIP code for placement search

First name

Last name

Email

Phone

Anything else we should know?

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Senior care, placed with care.

Free placement advisor service for families in Pierce County and South King County, Washington.

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Serving Pierce County & South King County · Washington State