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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 Potomac, we understand that deciding to seek in-home care for a loved one is never easy. It's a choice filled with emotion, hope, and the desire to provide the best for those who have always...
American Healthcare for Aging LLC is a home care provider that services Bowie, MD 20721. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care...
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 &...
Comfort Home Care LLC, provides in-home care, according to your schedule, your needs, and your individual personality, or that of a loved one for whom you may be primarily responsible. Comfort Home care is unique because...
At Golden Heart Healthcare Services, our mission is to deliver exceptional, compassionate, and personalized healthcare solutions that enhance the quality of life for individuals and families in our community.
Options for Senior America - Gaithersburg, MD is a home care provider that services in Takoma Park, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
At MyPillar Healthcare, we place a high priority on customer service and recognize that different customers have different needs. We have the experience and flexibility to truly understand a client’s needs, develop a care...
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. Based on...
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...
Best Care Home Care is a home care provider that services in Takoma Park, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When the time comes that extra care is required, whether due to age or health condition, many people prefer the familiarity and comfort of their own home. At Homewatch CareGivers®, we believe that good care should not...
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.
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...
Wendy and Todd Johnson opened the Senior Helpers Silver Spring office in 2007 because of their passion for helping others by delivering the best possible in-home care to seniors throughout the Silver Spring community....
Capital City Nurses CHC- Local/DC is a home care provider that services in Takoma Park, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
When discomfort stifles your life, we come to the rescue, peeling away layers of physical/ mental restriction through healthcare and healthy lifestyle changes.
About us Meet our founder Henrietta Jones RN is the founder and Executive Director of Hope Medical Staffing and Medical Consult with 23 years of experience in healthcare in homecare, mental health and hospital. She is...
We bring together compassionate caregivers and homebound individuals (such as the elderly and individuals of all ages that are chronically ill and/or disabled) so that they can remain safe and well and their family...
We believe that you can achieve significant results when you are recovering in the comforts of your own homes. Private duty nurses can provide quality assistance in process of recovery due to an illness or an injury. They...
Welcome to Woodlands Home Health Care, Let Our Home Care Services Work for You We are home care agency dedicated to providing professional, compassionate and specialized care to all of our patients in the comfort of their...
Amarah Care offers a wide range of services to meet your healthcare needs. From skilled nursing to therapy services, we provide personalized care to support your well-being.
Lintiso Healthcare Services is a home care provider that services Takoma Park, MD 20912. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care...
Bless America Home Healthcare Llc is a home care provider that services in Takoma Park, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to improve our clients’ and their families’ overall quality of life and health. We do this by offering our services with their health, safety, and comfort in mind at all times.
AG Healthcare Inc in Hyattsville, Maryland understands the importance of personalized care. We are a home care health agency that provides support services such as assistance with daily living activities and...
Welcome to Pleasant Care and Nurse Staffing! Pleasant Care and Nurse Staffing is your local source for reliable care. Our company is proudly a part of the community in Maryland, Washington, D.C. and Virginia. We serve...
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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.