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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:
At Homewatch CareGivers of Chantilly, our philosophy is guided by a simple yet powerful principle: to provide the kind of care we would want for our own family. This commitment drives us to match clients with caregivers...
With the desire to offer loved ones non-medical assistance at home with an option to remain safe, independent, and comfortable in their own homes, Graceful Hearts Home Care Service, LLC was formed. Our trained 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...
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 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...
Acti-Kare is a leading in-home care provider across the United States. For over a decade, our locations have personalized in-home care services around you, your loved one and the family. This allows you or your loved one...
Hearts at Home Care LLC is a leading provider of home care services, specializing in delivering compassionate, personalized care to individuals in the comfort of their own homes.
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
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...
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.
Tamela Fletcher opened the Senior Helpers Fairfax office to provide high-quality personalized senior care in the Fairfax and surrounding communities. Tamela recognizes the positive impact that Senior Helpers has on the...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
"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...
Caregiver provides home care services Nathaja HomeCare Mission Statement The mission of our Agency is to foster independence and maintain dignity for our clients. We work with our clients and their families to develop a...
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...
Each Family's Situation Is Unique You may be looking for continuous home care services, a non-permanent helping hand for a few hours a day, or just a professional assessment of your loved one’s care needs. Whatever...
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...
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...
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...
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...
Hello, I’m Karen Vassar, independent owner and operator of Griswold Home Care of Leesburg-Manassas-Woodbridge Virginia. My office team and I are committed to ensuring that our clients receive the highest level of...
Who We Are We are a group of licensed dedicated professionals who believe in providing trustworthy, quality, compassionate, and nurturing care to enhance the quality of life for those we serve while preserving their...
At Cherished Loved Ones we offer premium services the lowest possible costs. No longterm contracts or hidden fees. We service all ages throughout VA, MD & DC. Best of all we treat your Cherished Loved Ones as we would...
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.
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...
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...
Our Values - At FirstLight HomeCare, a leading home care agency, the genuine health and well-being of others is our greatest concern. We vow to provide first-class personal service for our clients so that they may enjoy...
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...
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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.