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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:
Heart Home Health Care LLC sounds like the kind of agency families hope to find when they need support most. Even just from the name, it gives a strong impression of compassion and a people-first approach—something that...
BridgePoint Home Health is dedicated to delivering high-quality compassionate home health services to all of our clients. Our fundamental priority is to uphold the dignity and independence of each individual we serve,...
At SMP Companionship and Care, LLC, we are dedicated to enriching lives in Woodbridge, Virginia, and surrounding areas through compassionate, personalized homecare. Our professional caregivers provide companionship, daily...
At Your Service VA is a mobile support company dedicated to enhancing the quality of life for seniors and individuals with disabilities. We provide compassionate, personalized care that helps our clients live...
The Executive Home Care Mission We work in a unique industry with unique opportunities to provide meaningful improvement in seniors’ lives. We also realize that this comes with great responsibility.
The demand for personal care at home for our elderly loved-ones has increased significantly in recent years. Although most in-home care is still provided by family and friends, many people are challenged when their loved...
Coneflower Home Care is a trusted senior home care agency with over 30 years of experience delivering compassionate, high-quality in-home support. We are dedicated to helping seniors maintain their independence and...
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...
Safe and Happy : That is what we all want to be. At Senior Care Safe at Home, our mission is to enable all adults to remain in the most desirable place of all: their own homes. Our goal is to offer the help and...
To provide quality home care by focusing on individual needs and bringing attentiveness to the unique lifestyle of each person. You can rest assured that our medically-trained and caring staff nurtures your loved ones,...
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...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
At Obioma Health Care Services, we believe that everyone deserves to experience the comfort and familiarity of home while receiving compassionate and personalized care. With a devoted team of healthcare professionals, we...
We've been there. We understand. Neither giving nor receiving care is easy. Home Instead® puts relationships first to support those giving care, to protect the dignity of those receiving care, and to enhance the quality...
Options Home Care of 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...
At For Better Home Healthcare our commitment is to transform the way in-home care is experienced by blending compassion, excellence, and truly personalized support. Our mission is to help individuals live safely and...
At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
Grace Providers is a family corporation that delivers professional, affordable care with personal touches. After over 20 years of field experience, we have redesigned home health care from the perspective of the client....
Spring Hills Home Care 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...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
1St American Home Health 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...
BJ Homecare in Virginia provides care and companion care for your loved ones. We understand the remarkable effects companionship can have on seniors’ health and happiness. When they engage with others and build...
GLOBAL CARE AGENCY is licensed, insured, bonded & Medicaid certified. We offer professional services in Northern Virginia, in the following areas: SKILLED NURSING SERVICES – oversee plan of care SOCIAL WORKERS – assist...
Bedrock at Home offers a unique and progressive lifestyle for individuals who find happiness in the comfort of their own home. Our innovative approach prioritizes your independence and provides a range of personalized...
Bunny Home Health Care, LLC 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...
We understand that not one care plan fits all. Daily services can include anything from meal preparation, hygiene, cleaning, and supervision. We will take the time to get to know you and develop an individualized care...
Above Unique, LLC 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...
Good Shepherd Nursing and Senior Care 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...
Ready 2 Serve Home Healthcare LLC is a locally-operated home health care agency servicing Alexandria, Virginia, and the surrounding counties. We specialize in rendering medical and non-medical care to our patients who are...
At HomeWell Care Services, we provide hourly at-home care for seniors and others who are struggling to manage day-to-day activities like grooming, bathing, cooking or even running errands. Our knowledgeable Care Managers...
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...
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...
Hallmark Home Care -Northern Virginia, Compassionate In-Home Care Services At MedPro Solutions DBA Hallmark Homecare, we are committed to providing high-quality, non-medical in-home care services that prioritize...
Your Caring Team consists of quality caregivers, care managers, and an agency director. Caregivers are the backbone of Caring Senior Service. We only hire caregivers that display a true passion for serving others and who...
Butters Home Health Care is 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,...
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...
We, at SE Home Care Service, are dedicated to improving the quality of life for children, adolescents and adults with developmental disabilities through increased access to integrated life choices including education,...
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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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.