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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:
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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
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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...
Heart Matters Home Health Care is dedicated to providing the best possible home care services for you and/or your loved ones. We staff licensed healthcare professionals to assist our clients with activities of daily...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
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...
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...
AESTAR Home Care provides compassionate in-home support, offering assistance with daily activities, personal care, mobility, meal preparation, medication reminders, and companionship. Their caregivers focus on dignity,...
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...
A Place At Home – Reston provides compassionate, professional, and dependable in-home care for seniors and families in Reston, VA, and throughout the surrounding areas of Chantilly, VA | Sterling, VA | Herndon, VA |...
At Homewatch CareGivers of Chantilly, our philosophy is guided by a simple yet powerful principle: to provide the kind of care we would want for our own family. This commitment drives us to match clients with caregivers...
At Home Care DMV, we started with a simple idea: to provide reliable and compassionate home health care services to those in need. Over the years, we have grown into a trusted provider of quality care, serving the needs...
Tamela Fletcher opened the Senior Helpers Fairfax office to provide high-quality personalized senior care in the Fairfax and surrounding communities. Tamela recognizes the positive impact that Senior Helpers has on the...
Orthocarern, Inc is a home care provider that services in Herndon, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Amended Home Healthcare, we strive to provide compassionate and personalized care for every client. Our mission is to enhance the quality of life for individuals in need of home health care services.
Our team of highly skilled professionals offers a range of services, including medical care, personal assistance, and companionship, tailored to meet the unique needs of each client
Selecting a Home Care provider is an extremely important decision. Your care provider will be coming into your home. You will want to find professional and trustworthy people that you feel comfortable with. NORVA Home...
Angelic Homecare LLC is a home care provider that services in Herndon, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Be Well Home Health Care, LLC is a home care provider that services in Herndon, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Always Best Care of Fairfax County and Herndon combines national strength and standards with local accessibility and personal service. Scott Maguire, the owner of Always Best Care of Fairfax County, is a long-term...
Senior Home Care Services, LLC is a home care provider that services in Herndon, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
Fairfax Home Health Care is a home care provider that services in Herndon, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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At Home Health Care LLC is a home care provider that services in Herndon, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Each Family's Situation Is Unique You may be looking for continuous home care services, a non-permanent helping hand for a few hours a day, or just a professional assessment of your loved one’s care needs. Whatever...
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Kind-Care, LLC is a home care provider that services in Herndon, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Options For Senior America - Western Fairfax County is a home care provider that services in Herndon, 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...
Our Home Health Options Group Inc. (HHO) was formed to provide an aging population and others with diminished physical capabilities with an option to stay at home and receive non-medical assistance. We will provide...
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...
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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...
Butters Home Health Care is a professional in-home care provider, assisting individuals and families who need one-on-one care of their loved ones. As a team of highly experienced, motivated, and dedicated associates,...
Our Values - At FirstLight HomeCare, a leading home care agency, the genuine health and well-being of others is our greatest concern. We vow to provide first-class personal service for our clients so that they may enjoy...
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.