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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:
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 Providence Care, Inc., we are devoted to making sure that our clients receive the personalized attention and care that they deserve. If you would like to learn more about our agency and what services we can provide,...
Green Life Home Care, LLC is a home care provider that services Springfield, VA 22150. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
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...
Options for Senior America - Gaithersburg, MD is a home care provider that services in Arlington, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Amada, quality care is our priority. We look for ways to make simple, everyday tasks special. Amada’s in-home caregivers not only take care of daily essentials like cooking, cleaning and grocery shopping, but they also...
Home Care Solutions Tailored For You Personalized Attention for All Your Health Related Needs If you or your loved ones are facing health problems, temporary or chronic, it may be time to reach out for help. At Indigo...
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...
We’re proud to serve families across Arlington & Alexandria and the Southeast Fairfax areas including the surrounding communities of Springfield, Mt Vernon, Kingstowne, Fort Hunt and Lorton.
More than just a caregiver, we assign each client a care team. Our thoroughly-vetted and qualified caregivers are there to provide care to clients, with the support of a remote Care Team
Better Days Home Healthcare Professionals, LLC, Compassionate In-Home Care Services At Better Days Home Healthcare Professionals, LLC, we are committed to providing high-quality, non-medical in-home care services that...
More than just a caregiver, we assign each client a care team. Our thoroughly-vetted and qualified caregivers are there to provide care to clients, with the support of a remote Care Team.
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
Home Helpers® Home Care is a in-home care service that provides top quality in-home care and in-home supportive services. Our Cared-4℠ program is a holistic approach to meet the four primary areas of need, helping your...
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...
My Privilege Home Care, LLC is a home care provider that services in Arlington, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
At Alpha 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...
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...
ACCfamily is a family-owned, veteran-founded home care agency with over 31 years of experience serving Northern Virginia. Rooted in our commitment to love and serve others, we provide compassionate, personalized care that...
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.
Empowering Independence with Trusted In-Home Care and Companionship Sencura brings compassionate support and trusted companionship to seniors and adults with disabilities. Our reliable, in-home caregiving services are...
We know from first-hand experience with our parents, in-laws and children, how stressful both caregiving to those that need it, and picking a quality home care provider, can be. We are here to help with the worry, fear...
BG HealthCare Services is a trusted non-medical in-home care agency dedicated to supporting seniors and individuals who need daily living assistance. The agency provides personalized services such as companionship, meal...
Chase Home Care caregivers are trained and experienced in providing additional personal care and physical assistance for seniors at home who may be experiencing limited mobility or cognitive changes. Caregivers lovingly...
Here at Comfort Keepers of Arlington, VA every member of the team from the administrative and support staff to our amazing caregivers in the field shares in the same goal, to provide our client with superior care. Each...
At Noble Home Health Care LLC, our mission is to empower our patients to live independently and maintain their sense of freedom as they age. Our dedicated care team members work closely with clients, their families, and...
Home Instead is a home care provider that services in Arlington, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At “We Care Providers Inc.,” our journey began in the heart of Northern Virginia, inspired by the love and compassion that arises from family caregiving. As the co-founders, my husband and I embarked on this mission after...
Agency Description Lavender Cares Agency, Compassionate In-Home Care Services At Lavender Cares Agency, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort,...
Cherish Home Health Care is a home care provider that services in Arlington, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Visiting Nurse Solution is a home care provider that services in Arlington, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Wellness Home Healthcare, LLC is a home care provider that services in Arlington, 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...
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...
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...
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...
At Assisting Hands Home Care, we understand. Our trained dependable caregivers and personal assistants can help overcome those challenges, and make home an even better place to be. We include everything from...
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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.