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Fill out this
Disclosure & Acknowledgment Form**
Making the senior care process simple, transparent, and stress-free is at the heart of what we do. Before we begin working together, we ask every family to review and complete our Disclosure & Acknowledgment Form. This ensures you understand how our placement services work, what you can expect, and how we support you throughout the entire journey.
Our goal is to keep everything clear and upfront so you always know exactly where you stand — no confusion, no pressure, and no hidden commitments.
Why This Form Matters
This form gives you a quick overview of:
How our no-cost placement services work
What information we use to help guide your senior care search
How we communicate with you and potential communities
Your acknowledgment that we are acting as your placement provider
The support you can expect from our team throughout the process
Completing this form allows us to begin reaching out to communities, advocating for your needs, and guiding you toward the right next step.
AZ Senior Placement Advisors – Disclosure & Acknowledgment
Please complete this form. After you sign and check the acknowledgment box, click “Generate & Send PDF.” A signed copy will be saved to your device and emailed to our office for records.