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:
Capital City Nurses CHC- Local/DC is a home care provider that services in Rockville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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At Perissmos Healthcare Services Inc, we believe care should feel personal and empowering. Our attentive caregivers deliver tailored support—from daily routines to emotional companionship and condition-specific...
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...
Ready 2 Serve Home Healthcare, LLC - Chevy Chase, MD is a home care provider that services Chevy Chase, MD 20815. Home care services allow seniors to remain safely in their own home while receiving medical care or...
What Makes SYNERGY Different? Reliability SYNERGY HomeCare's Care Team can be relied upon to be at their assigned shift as scheduled. SYNERGY HomeCare utilizes a telephony system allowing us to know when our caregiver...
About Griswold Home Care Griswold Home Care now operates in more than 200 locations across 30 states, touching more than 100,000 families. As the category pioneer, we have a unique position and understanding of...
At ITERU Health Care, we believe every client deserves care that listens and responds. Our experienced caregivers provide customized assistance—from daily living support to heartfelt companionship and specialized...
Senior Helpers Rockville is committed to delivering the best possible in-home care to seniors in Montgomery County. Our top notch caregivers have a passion to serve you or your loved by providing companionship and...
2nd Family - Eldersburg is a home care provider that services in Rockville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allset Home Health is a non-medical in-home care agency based in Maryland, dedicated to providing compassionate and reliable support for individuals needing assistance with daily living activities. Their services include...
We believe that people stay healthier, longer by living with liberty and dignity at home, the place they want to be. That philosophy motivates everything we do and embodies our culture and values. Our purpose is to help...
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...
Life is Better with Villi of Montgomery At Villi, we believe “It takes a village,” and we’re here to be that village for you and your loved ones. Our mission is to bring comfort, joy, and a helping hand to your daily...
Choosing a reliable Home Health Care Agency is a crucial step to ensuring your family members will have the level of care they deserve. The needs of your family are always in our focus and everything we do is dedicated to...
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...
Comfi-Kare LLC provides essential home care services in Gaithersburg, MD, supporting seniors with personal care, medication management, companionship, skilled nursing, household help, transportation, respite care, and...
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...
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 &...
Premium Home Health Care is owned and operated by true healthcare advocates along with a team of exceptional talents who deeply understand not only what it means to be a caregiver but most importantly, to be a care...
At Direct Home Nurturing LLC, you are our number one priority. We want you to focus on living life the fullest and achieving independence in the comfort of home with the services that we have prepared for you. Together...
1. A care team led by a Registered Nurse that develops and implements a personalized care plan for each client 2. Experienced, compassionate, and highly trained caregivers 3. On-going training and Development for all...
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...
Options for Senior America - Gaithersburg, MD is a home care provider that services in Rockville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care For Me Home Care Services is a home care provider that services in Rockville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Adonai Family Healthcare LLC, we’re dedicated to delivering compassionate, comprehensive, and accessible healthcare to every family. Our community-focused approach provides personalized medical services for families...
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...
Best Care Home Care is a home care provider that services in Rockville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Philia is a Home Care Agency in Washington, DC providing senior and child care services. Our focus goes beyond our clients’ safety and health as we incorporate activities into the care plan to address their emotional...
Right at Home is an in-home care and assistance agency, providing quality senior and disabled persons care since 1995. We provide trained, insured and bonded caregivers for a variety of caregiving needs. Whether it's...
Exceptional Staffing Solutions LLC is a home care provider that services in Rockville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Capitol Home Care, LLC is a home care provider that services in Rockville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Capital Home Care provides home care for elderly and those with physical or intellectual disabilities in the state of Maryland, and in the state of Virginia.
ComForcare understands that today's busy lifestyles often deprive family members of the time necessary to provide hands on assistance and companionship for their loved ones. Therefore, we want every family we service to...
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We aim to provide high quality care to our clients and uphold their independence working with each individual's schedule. Having reliable and trained staff is what we offer. You, your loved one, and your family matter...
Finding home care services for your aging loved one that will ensure a good quality of life can be challenging when this is your first time considering extra assistance. Fortunately, our Caregivers at Home Helpers Home...
Celtic Healthcare Of Maryland is a home care provider that services in Rockville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Potomac Home Health Care is a home care provider that services in Rockville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Smithlife Home Care of Maryland is a home care provider that services in Rockville, 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 the best professional home health care services for seniors, children (pediatric) and disabled in the comfort of their home. The care and services will be provided to patients with dignity,...
Our mission is dedicated to enhancing the lives of people with intellectual and developmental disabilities by empowering them in their quest for independency. Our organization works hard to ensure that each person’s...
Victory Home Care. Leading Home Health Care In Maryland. Victory Home Care is dedicated to offering in-home care in Maryland. With a clinically focused approach, we are here to provide the best quality care to our...
At Genesis Homecare Services, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence. Our mission is to support individuals in leading fulfilling...
At Interim HealthCare of Montgomery County, Maryland, we provide a wide range of in-home healthcare services. Whether in need of skilled nursing, Infusion therapy, wound care, physical therapy or other home healthcare...
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...
We Are Thrilled to Introduce LM Healthcare: Your Trusted Home Care Partner in Maryland For the past 8 years, LM Healthcare has proudly served as a reliable and compassionate home care/private duty agency across the state...
We are a premium home care agency with sophisticated and mature caregivers who can relate to clients. We match caregivers and clients with complementary personalities and similar interests. The result is service that...
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.