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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:
Senior Helpers Baltimore is the premier provider of in-home senior care. We offer tailored home care services ranging from companion care for seniors who need daily assistance to in-depth specialized care for those with...
Griswold offers compassionate in-home care for those who want support to live where they love. With over four decades of experience and a storied legacy of compassion and integrity, we focus on the people we meet and the...
Capital City Nurses - Columbia is a home care provider that services in Columbia, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Staffing on the Go was created to solve the complicated nature of hiring quality talent and finding quality jobs in the medical field. Our experienced staff goes through the critical process of verifying every job &...
Yad Lae Zeerah is a dedicated health care provider committed to offering affordable and comprehensive care solutions. Our mission is to ensure that high-quality health care services are accessible to all, regardless of...
A Homemade Plan is a hardworking and caring home care company that is dedicated to its patients, clients, care providers, and community. We are a locally owned and operated company based in Maryland. We help those who...
At AllCare Advanced Home Care, our mission is to provide compassionate and personalized home health care services to our clients. We strive to improve the quality of life for those we serve, while prioritizing their...
Welcome to Golden Homecare, your premier destination for exceptional home care services in the vibrant community of Anne Arundale County, PG County, Howard County, and Montgomery County, Maryland, and its surrounding...
At GAVA Healthcare, we are a licensed home care agency serving Maryland. As a locally owned family business, we are dedicated to providing compassionate and personalized care services to people of all ages. With a deep...
Options For Senior America Corp. started providing home care services in late 1989 to the residents of the Washington, DC metropolitan area. What started as a handful of customers grew substantially due to the personal...
Raquel Micit, owner of Amada Senior Care Silver Spring, understands that choosing the right in-home care company for a senior loved one is a life event that most families are not prepared for. As a senior care advocate...
Noble Healthcare Services is a home care provider that services Laurel, MD 20708 and surrounding areas. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our vision Is to prioritize patient safety and training, tailoring our services to unique needs and offering 24/7 assistance. Our goal is to improve quality of life and promote independence, dignity, and peace of mind.
Shiloh Healthcare, LLC (Shiloh) is a Maryland State LLC based in Frederick, Maryland. Shiloh Healthcare provides dedicated, committed, and tailored sterling healthcare services for our clients at the comfort and pleasure...
Our Value We strive to provide the Best Quality Home Care. We Promote: Affordable High-Quality Health care A culture of Compassion and endurance Ethics and Integrity Cultural Awareness and Diversity
Our mission is to serve the community by providing excellent, affordable, and compassionate care to all our clients; to support and ensure that our clients can live independently in the comfort of their own homes.
At A and R Homecare our motto is treat our clients like we would want to be treated. Our caregivers will provide care that ensures your loved ones are treated with the dignity and respect they deserve.
With a staff that has been thoroughly screened for competence, our care services are explicitly designed to improve your quality of life and help you heal in the comforts of home. In fact, we not only focus our services...
BrightStar Care of Howard County, MD is a home care provider that services in Columbia, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care that moves you. Welcome to SYNERGY HomeCare of Columbia providing up to 24-hour home care. Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare of Columbia...
At Mercy Care, we strive to provide meaningful in-home care to all our clients by clearly defining our individually tailored care plan to meet the patient’s needs 24/7.
Welcome to Braveheart Healthcare Solutions, a licensed and insured healthcare provider dedicated to delivering compassionate care to patients. We are committed to providing the highest quality services to our clients,...
FirstChoice is an Innovative Adult at home care provider. FirstChoice provides temporary, longterm, transitional and live-in adult care solutions in the comfort and privacy of your home. Our customized solutions...
At AMBIENT SOLUTIONS, we are dedicated to supporting individuals with developmental disabilities through a range of comprehensive and compassionate services.
Stay at Home Nursing and Companion is a home care provider that services in Columbia, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A and R Homecare is a home care provider that services in Columbia, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
My Friends Retreat is a non-medical in-home care agency based in Baltimore, dedicated to providing compassionate and personalized care services to seniors and individuals with disabilities. Our highly trained caregivers...
Gentiva Certified Healthcare is a home care provider that services in Columbia, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Krowne Health Care is a home care provider that services in Columbia, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
In-Home Health Care is a wise choice for individuals and families in many different situations, from those who are recovering from surgery or a serious illness, to the elderly or disabled, or maybe you just need a little...
Best Care Home Health Services is a home care provider that services in Columbia, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Happier at Home Care, LLC is a home care provider that services in Columbia, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
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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.