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:
At Embrace Quality Care, we are committed to providing exceptional non-medical home care services. Our focus is on delivering compassionate care with a touch of cheerfulness, ensuring the well-being and happiness of our...
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At Visiting Angels, we strive to make staying at home a positive experience. We do this by allowing you to select your caregiver from a group of skilled elderly home care providers, allowing you to maintain your schedule,...
Here at Senior Helpers – Virginia Beach, we are a Veteran owned and operated home health care franchise located in Virginia Beach. We provide high quality personal and companion care to individuals in the comfort of their...
Better Days Home Health, established in Hampton Roads, is dedicated to delivering personalized, compassionate care. Inspired by a neighbor's experience, we've made it our mission to ensure comfort and dignity in your own...
Our Norfolk location delivers reliable home care services to help your loved ones stay at home. We help seniors maintain their independence by supporting them where they need it. Whether you need dementia, Parkinson's,...
When you rely on Visiting Angels to provide home care services for your family, you expect your loved one’s needs will be met. The expertise of our elder care providers makes it possible for us to provide a wide range of...
Cherished Home Services LLC accommodates seniors and dependents needing Skilled Nursing Services and non-medical assistance at home, with the option that most people prefer – to remain independent, comfortable, and safe...
Home Health Agency in Virginia Beach VA and Northern VA. With us, you can guarantee the best home care experience at the most affordable price. We always strive to offer excellent services that meet all of your needs, no...
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Faith Journey Home Care LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Home Health Services LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
C & R Divine Hands of Care, LLC is a home health care agency based in Virginia Beach, Virginia. Founded in 2015, the company specializes in providing medical and home health solutions, including medical case management...
YNOT WELCOME YOU HOME HEALTHCARE INC. is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hope, Care & Love Home Healthcare Services, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
Beyond Believers LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission Our mission is to provide exceptional home care services that empower individuals to live independently while receiving the support necessary to uphold their dignity and quality of life. We are dedicated to...
Heartland Home Health&hospice is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cozy Home Care of Virginia is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With Loving Hands, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Atlantic provides a wide range of homecare services including non-medical companion and personal care, as well as, both pediatric and adult private duty nursing. Our professionals partner with our clients and their...
Our Mission Adom Care At Home is committed to providing quality care to the elderly and the sick while they age comfortably in their homes and or recover from Illness and injury.
Concierge Care in the Comfort of Your Home We are committed to delivering unparalleled home care services to the senior community throughout Virginia. Located in the heart of Virginia Beach, our mission is to Bring Joy...
Val's Home Care, LLC 📍 900 Commonwealth Pl STE 200, Virginia Beach, VA 📞 757-966-8248 Welcome to Val's Home Care, LLC, where compassionate care meets the comfort of home. Located in the heart of Virginia Beach,...
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Whether providing short-term assistance or long-term support, our team is committed to enhancing well-being and fostering peace of mind for both clients and their families.
Trinity`s Heart Home Care LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Care with Empathy LLC, we're more than just a home care company- we're your trusted partner in providing compassionate, personalized care. With a dedicated team of experienced caregivers. We understand that each...
Deloris Home Health in Virginia Beach, Virginia provides comprehensive home health care services to residents in the area. Their offerings include skilled nursing care, physical therapy, occupational therapy, speech...
A & C Alternative Care is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Peace & Love Home Care LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Above Best Care LLC provides exceptional in-home care services tailored to meet the unique needs of seniors and individuals requiring assistance. Our compassionate caregivers prioritize comfort, safety, and independence,...
CARING 4 YOURS 2 LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Loving Touch Home Care, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Taste Of The Kingdom LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
GreenLight HomeCare Services, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
CM Health Solutions is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Priority Home Healthcare of Virginia, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Morningside Home Healthcare, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
our mission is simple yet profound: to provide dependable support and caring service in a family atmosphere. We believe that every individual deserves to age with dignity and independence within the familiar embrace of home.
With Care Advantage in-home care locations across Virginia, we are poised to deliver the best possible services to all manner of clients in their home. We vow to make a positive contribution in the communities we serve...
Honesty Home Health, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Changing Tides Home Care supports your loved one’s independence and well-being. We work closely with you to develop an individualized care plan, and to match you with caregivers who are well suited to your loved one’s...
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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.