Are you sure you want to exit? Your progress will be lost.
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.
✔
I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
✔
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...
Engage, Enrich, Empower Care in the Home: Five simple but trans-formative principles 1. Learn and grow together. Loved ones with Alzheimer’s or other forms of dementia, can continue to take pleasure in their favorite...
Companionship Assistance: Emotional well-being matters. We understand the importance of social interaction in elder care and provide dedicated support .Assistance with ADLs: To foster dignity and independence, we...
At Mon's Homecare, we believe that compassionate care begins at home. Our experienced caregivers provide personalized assistance with daily activities, companionship, and specialized support, ensuring each client...
A Place At Home is a company that focuses on providing personalized, compassionate care for seniors, offering services such as in-home care, assisted living, and memory care. With a mission to help older adults live...
We proudly offer a wide range of non-medical services including personal care assistance, bathing, grooming, and dressing, toileting and incontinence care, mobility and transfer support, medication reminders,...
Experience a happier, healthier life at home. We know there’s no place like home. That’s why HomeWell brings you the highest quality of care so you can maintain your independence and experience life to the fullest.
Gracie Care LLC is a Silver Spring, Maryland–based home care agency providing compassionate, non-medical in-home support. Services include personal care and companionship designed to help individuals maintain...
We understand that the first step in determining what type of care is most appropriate is to first meet with a client for a complimentary in-home assessment and visit. Our goal is to help you experience the least...
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...
The Prime Placement of Baltimore, Compassionate In-Home Care Services At The Prime Placement of Baltimore, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity,...
Senior care services from Home Instead® help to enhance the aging experience by providing practical support at home with a human touch. Our professional caregivers immerse themselves into wherever home is to assist with...
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...
For quality in-home senior care services in Baltimore, you and your loved one can count on, turn to Homewatch CareGivers®. Our experienced team of qualified care professionals undergoes extensive background checks and...
At SYNERGY HomeCare, we build connections and forward momentum in people’s lives. We call it the Synergy Effect. We believe our purpose is to provide the best care possible. Equally important is helping people feel, see...
Home Instead® is a reliable source of home care for seniors in the West Baltimore and Howard County area. Services include companionship, meal preparation, light housekeeping, med reminders, shopping, errands, more. We...
At SYNERGY HomeCare, we build connections and forward momentum in people’s lives. We call it the Synergy Effect. We believe our purpose is to provide the best care possible. Equally important is helping people feel, see...
A Homemade Plan: In-Home Senior Care A Homemade Plan (formerly Angels of Care) is an in-home senior care company that provides Caregivers in the homes of senior citizens and people who have disabilities to assist with...
Our mission is to enrich every lives we encounter, we are dedicated to providing experienced caregivers, quality patient care with relentless attention to clinical excellence, patient safety and consistency to ensure...
Centry Care Plus is a non-medical service that provides emotional support, socialization, and practical help for adults who want to maintain their independence. Services include companionship, assistance with errands and...
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 Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
Home Instead® is a reliable source of home care for seniors in the Anne Arundel County area including Annapolis, Edgewater, Arnold, Severna Park, Pasadena, Crofton, Millersville, Odenton, Odenton. Services include...
Experience the benefits of personalized assistance in the comfort of your own home. Our dedicated caregivers offer support with daily activities, companionship, and specialized care, ensuring that you or your loved ones...
We are committed to quality home health care for our clients through professional caregivers, a thorough plan of care, and superior execution of our services.
Blessed Angels Home Healthcare Services extends a warm welcome to you our client and to your family and friends. Your medical treatment, safety and happiness are most important to us as we will do our best to answer any...
Their mission is to deliver professional, compassionate care and rehabilitation for individuals with acute, chronic, or terminal conditions, while their vision is to become a leading provider of innovative, home-based...
Capital City Nurses - Columbia is a home care provider that services in Baltimore, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mia Dalcour understands firsthand the challenges of caring for an aging loved one. After her mother suffered from a stroke and began requiring assistance with her daily tasks, Mia learned the importance of reliable...
2nd Family - Eldersburg is a home care provider that services in Baltimore, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Trustworthy Staffing Solutions is a Residential Service Care Agency established and designed to provide quality, cost effective in-home nursing and personal care for the adult and pediatric medically impaired.
Experienced and Supportive We understand that not one care plan fits all. Daily services can include anything from meal preparation, hygiene, cleaning, incontinence care, blood glucose monitoring, medication...
Since 1996, Always Best Care has helped thousands of families with non-medical in-home care and assisted living referral services. Our passion for helping people maintain a safe, independent and dignified lifestyle...
Watchen and William Bruce, the owners of Amada Senior Care Nottingham, are deeply passionate about delivering high-quality senior care to their community. Watchen and William’s commitment to this vital service is rooted...
Comprehensive Home Health Services is a home care provider that services in Baltimore, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Griswold Home Care for Anne Arundel & Queen Anne's Counties, MD is a home care provider that services in Baltimore, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Complete Home Care was established in order to assist you or your loved one overcome any burden. As a local Residential Services Agency, we pride ourselves on offering the most comprehensive home care services.
Our primary objective is to bring more enjoyment to the lives of those who find it increasingly difficult to function well on their own. We remove the burden of stress from both the person needing assistance as well as...
Senior Helpers Severna Park provides a full range of senior home care services for you or your loved one—from companionship and housework help, to more complex care services, including disease management, Live-In and...
Help at Home Services’ mission is to provide superior service through the same care, concern and compassion that we give our own families. With our 15 years of experience as a Residential Service Agency, licensed by the...
To improve quality of life for those we serve through the delivery of clinical excellence, extraordinary service and compassionate care, while being recognized as the leader in home health.
Johns Hopkins Home Care Group is a home care provider that services in Baltimore, MD. 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...
We are a family-based residential service agency providing safe, respectful, and dignified non-medical home health care to veterans and adults of all ages throughout Baltimore, Carroll, and Howard counties.
We at Griswold Home Care Referral Service realize that every home-care situation is unique and that having the correct type and amount of care for your loved one is what provides our clients with peace of mind. Whether it...
At Freedom Home Care, we are dedicated to providing the highest quality of care in the Home Care Profession. We are a bonded and insured non-medical home care agency serving the Anne Arundel County Area. We provide...
Founded in 1966, Interim HealthCare is the nation’s first home care company and a trusted provider of home healthcare, personal care and support, hospice care and medical staffing services.
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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.