Read the statement, add what you can below (a few words each, all optional), and Send signs it with the name you entered.
Washington disclosure statement, dated October 23, 2026, under the Elder and Vulnerable Adult Referral Agency Act (RCW 18.330).
(a) Agency: MyLivingChoice LLC (MyLivingChoice.com), 8705 N. Cypress Ct, Kansas City, MO 64156, (816) 226-7772.
(b) Client: the person sending this request.
(c) Fees: you pay us nothing. If you hire an agency we introduced you to, or whether or not you do, that agency pays us a flat fee for the introduction, billed to the agency monthly. If you ask, we will tell you the amount of the fee for any agency we refer you to.
(d) Services: MyLivingChoice is a free service that helps families find senior living and care at home. We gather a short intake about the care needed, suggest agencies that appear able to meet those needs, and introduce you to the ones you choose. For you specifically, we will introduce you to Chesterfield Services LV and share with it your name, contact details and the care needs you described, nothing more.
(e) We will never ask you to waive any claim for loss of personal property or injury, or any right you have under state or federal law.
(f) We work with both you and the agency in the same transaction: the agency pays us, and we are introducing you to it. To obtain or share confidential health care information about the person who needs care we need your authorization, which you give for the agencies named above by acknowledging this statement.
(g) Tours: we do not tour agencies as a matter of course. Our information comes from the agency itself, its state licence record and public sources. We have not toured Chesterfield Services LV.
(h) You may stop using our service, or switch to another referral agency, at any time and for any reason, with no penalty and no cancellation fee.
(i) Refunds: because you pay us nothing, there is nothing to refund to you. If a community pays us a fee for your placement and the resident dies, is hospitalized or moves to another setting for more appropriate care within the first thirty days after admission, we refund the community a prorated share of the fee for the days not used, as RCW 18.330.090 requires.
(j) Complaints about a referral agency may be filed with the Washington State Office of the Attorney General, Consumer Protection Division (Consumer Resource Center), 800 5th Ave, Suite 2000, Seattle, WA 98104-3188, 1-800-551-4636 in Washington, 1-206-464-6684 from outside the state, https://www.atg.wa.gov/file-complaint.
(k) Neither MyLivingChoice nor anyone who works on referrals for it, nor their immediate family members, has any ownership interest in any agency we refer families to.
