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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:
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
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Bella Desai opened Senior Helpers of Arlington/Alexandria office in 2018, and has been building an exceptional team of care professionals ever since. After caring for her grandmother and seeing the various types of...
Burlee Oaks is a home health care agency located in Fairfax, Virginia. We are a quality-centered agency, dedicated to providing comprehensive in-home care services in the comfort and privacy of the patient's home. As a...
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client.
Care isn’t just what we do, it’s who we are! Our compassionate caregivers and the families we serve are our number one priority. We go above and beyond to ensure every client’s needs are met. We are dedicated to...
Comfort Home Care Services has been a proud member of the local Stafford, Virginia community since 2010. We provide the most exceptional level of care to your loved ones by treating them as our own. We strive to enhance...
Options for Senior America - Gaithersburg, MD is a home care provider that services in Alexandria, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
If you are looking for elderly companion care or senior home care services in Alexandria, VA, turn to the caring team at Philia. Our home care nurses are dedicated to going beyond the basics and providing exceptional care...
Absolute Home Healthcare focuses on delivering compassionate, client-centered care tailored to meet each individual's unique needs. Services include assistance with daily living activities, medication management, and...
YOUR PARTNER IN PROFESSIONAL IN-HOME SUPPORTIVE SERVICES At Home Helpers® Home Care in Concord, CA, we are dedicated to providing professional in-home supportive services that help seniors and adults remain safe and...
With home care services, our office can provide personal care plans through an in-home evaluation and interviews between the client, family and the ComForCare team to help determine the best plan of action for the...
Adonai Home Care Services is a home care provider that services in Alexandria, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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At Halo Helpers, we understand that the comfort of home is the best place for your loved ones to receive care. Our specialized services cater to a wide range of needs, from daily and weekly assistance to those recovering...
"Check out the information below to learn more about Brightside Home Care Service LLC:" We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or...
Established to meet the growing needs of families in 1998, Medical Professionals On-Call is a home care service provider servicing Fairfax, Virginia and its’ surrounding areas. As experience home care providers, we offer...
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Virginian Home Health Care, Inc. is committed to providing high quality Personal care essential to the improvement of physical, mental and social conditions of our patients. We want to be the home care company of...
Guardian Angel Home Health - Alexandria, VA is a home care provider that services in Alexandria, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Our in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing compassionate care in the...
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Our Home Health Options Group Inc. (HHO) was formed to provide an aging population and others with diminished physical capabilities with an option to stay at home and receive non-medical assistance. We will provide...
We are a dedicated healthcare provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity.
Elite Eldercare NoVa is a home care provider that services in Alexandria, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
he Mission of Fassity Home Care LLC is to provide a level of quality care that encourages the safe and cost-effective delivery of home health services. Vision Our vision is to maximize patient autonomy with...
BeattyCARE Home Health Services is a locally-owned and operated health care provider stationed in Virginia. Our services are offered by caring, experienced, and competent nursing professionals. The focus of home health is...
Wonders Home Healthcare provides our clients with unparalleled healthcare services that are designed to meet their unique needs. We are always happy to help each individual be as comfortable as possible under our care. We...
Allied Home Care is a home care agency in Alexandria, Virginia that is committed to provide high quality, client-centered and customized in-home services to our clients. A collaboration of nurses, therapists, home health...
At Hope and Recovery Care, we are ready and eager to serve your loved ones with a team of professionals who have expertise in patient care and health recovery. We specialize in nursing care, personal care, and recovery...
We are a professional in-home care provider, assisting individuals and families who need one-on-one care of their loved ones. As a team of highly experienced, motivated, and dedicated associates, we are committed to the...
Gayflor CareConnect was established in 2024 with a mission to provide exceptional in-home healthcare services. As a nurse-owned company, we have a profound understanding of the importance of providing compassionate and...
Serving Fairfax, Alexandria, Arlington and surrounding areas, Griswold Home Care of Northern Virgina can help you remain independent, active, and safe in your own home. Our goal is to provide you with assistance as you...
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Comfort Keepers of Alexandria, VA is a home care provider that services in Alexandria, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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One of our advisors will contact you soon to connect you with trusted sources for care in your area.
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.