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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.
✔
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:
Allied QualityCare LLC is a trusted provider of compassionate and reliable home care services, dedicated to supporting individuals and families with personalized care solutions. Our mission is to enhance the quality of...
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 &...
Capital City Nurses CHC- Local/DC is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Wellington Care and Services WCS is a home-care service available to support your independent lifestyle that services four different counties within the District of Columbia and Maryland. We dedicate at least...
Key Services Offered Merimax Health Care Services provides a range of in-home support and health-related services, tailored to individuals needing both medical care and personal assistance. Services include: Personal...
Senior Helpers of Southern Maryland is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Providing quality in-home care at affordable rates since 1989. Assistance in personal care including help in bathing, showering, dressing, grooming, meal preparation, medication reminders, companionship, transportation to...
A Homemade Plan of Lanham, MD is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Options for Senior America - Gaithersburg, MD is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Sarah’s Peace and Love, we are committed to providing high-quality, customized and affordable home care services to our clients to assist them in the comfort and safety of their homes.
Inpak Healthcare LLC is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Majestic Assisted Living Home is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Community Aide Home Care Services provides a solution for your family’s health care needs. Our services are tailored to your needs and combine the best healthcare services in the convenience of your home. We are very...
AB Serenity Sprout Health Care LLC is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SO MD Home Health Srvcs, Inc is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Global Healthcare Solutions - Maryland is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sky Heath Care Solutions - Delaware is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sunshine On The Go provides an alternative to the traditional solutions of nursing homes or other retirement facilities. Sunshine On The Go provides skilled nursing care for children, adults, and seniors in the comfort of...
Sky Health Care Solutions - Pennsylvania is a home care provider that services in Clinton, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
We are a certified care provider in Washington, DC, offering personalized, compassionate support through a team of experienced and diverse professionals. With a strong focus on safety, engagement, and attention to detail,...
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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.