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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:
Established to meet the growing needs of families in 1998, Medical Professionals On-Call is a home care service provider servicing Fairfax, Virginia and its’ surrounding areas. As experience home care providers, we offer...
Tamela Fletcher opened the Senior Helpers Loudoun office to provide high-quality personalized senior care in the Loudoun and surrounding communities. Tamela recognizes the positive impact that Senior Helpers has on the...
Herewith is a mobile and online platform for families to find, hire, and manage flexible, affordable in-home care for older adults. Unlike an agency, on Herewith there are no hourly minimums or subscriptions, you set your...
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.
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...
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.
Faith Compassion Home Care is owned and operated by compassionate individuals that are following their true calling in life: to serve and care for others! We get satisfaction from serving our patients in their homes...
We work to perfect our care giving process. Our caregivers makes it possible for the old or needy person to maintain as much freedom as possible. By providing the suitable in-home companionship and assistance, we allow...
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 Attend Home Care, our mission is to provide five-star quality home care services with kindness and respect. We believe that every individual deserves to be provided for with dignity, so we offer compassionate care...
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...
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...
1st Americare, LLC is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angel Senior Home Care is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are expert caregivers with an intimate understanding of our patients' and their families' needs, enabling us to customize programs to deliver proactive in-house care that improves the quality of life while maintaining...
Why move to a facility when you can receive the same services in your home? Older adults want to live on their own terms, where they want to live and how they want to live. Autonomy, dignity and choice.
Loving Angel's Health Care is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sabah Home Care, LLC is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Feel better in the comfort of your own home. We specialize in care and daily living assistance to an array of individuals. Whether you need daily or weekly assistance due to aging, illness, recovery, or rehabilitation,...
ABP Senior Home Care, Inc. is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
DO NOT CALL Stay at Home Care LLC is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Dynamic Home Health Care is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
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...
Gayflor CareConnect was established in 2024 with a mission to provide exceptional in-home healthcare services. As a nurse-owned company, we have a profound understanding of the importance of providing compassionate and...
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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.