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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:
Enhanced Healthcare Services, LLC provides high-quality in-home care services. In-home care can be a great solution for individuals who need assistance with daily activities but wish to remain in the comfort of their own...
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...
Homewatch CareGivers of Woodbridge, VA is a home care provider that services in Dumfries, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Searching for a like-minded friend to help tackle chores and tasks? Do you seek a companion to join you in hobbies and activities? Our caregivers – seniors themselves – show up ready to exceed expectations – on a schedule...
Our Agency offers companionship and personal care to senior citizens and other clients who need assistance due to adverse health or medical conditions. Our home care services enable our clients to remain independent and...
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...
Home Helpers® Home Care is a home healthcare service that provides top quality in-home care. Our Cared-4℠ program is a holistic approach to meet the four primary areas of need, helping your loved one stay safe and...
Beth Tilahun opened the Senior Helpers office of Woodbridge to match the growing need for in-home senior care services in the community. Caregivers at Senior Helpers Woodbridge develop a close, trusting, and professional...
At SMP Companionship and Care, LLC, we are committed to enhancing the quality of life for individuals in Woodbridge, Virginia, and surrounding areas by providing compassionate and professional homecare services.
As a home care agency in Dumfries, Virginia, Live With A Purpose Home Care LLC’s lifelong duty to direct individuals to a path where they can lead better lives. We work closely with every client so we can help them cross...
Nestwell Health is your trusted partner in providing exceptional non-medical in-home health services in Dumfries, VA, and surrounding areas. We are committed to enhancing the well-being and quality of life of our clients...
At Best Hope Home Healthcare, LLC we are committed to serve both children and adults with special HealthCare needs.Our goal is to provide quality care in a courteous, efficient, and professional manner. We deliver quality...
Eveready Home Care, LLC is a home care provider that services in Dumfries, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OptimumCare Home Care is a provider of home care service in Woodbridge, Virginia, that is dedicated to meeting the needs of individuals in home-based scenarios.
Maintaining independence and dignity is vital to seniors’ quality of life. GraceStar Home Health LLC offers personal care services to support daily activities such as bathing, dressing, and grooming. Our compassionate...
Rose Hill Healthcare Resources is a home care provider that services in Dumfries, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Expert Care Home Health, LLC is a home care provider that services in Dumfries, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our company is based on the belief that our customers' needs are of the utmost importance. From the office to the field, our entire team is committed to meeting those needs. Roses Home Healthcare, LLC is licensed and...
Alliance Care LLC was formed with the belief that health and Care should be finely personalized, Our hallmark is offering continuity of care to our clients. The founders of Alliance Care LLC are seasoned health care...
1st Option Home Health, LLC is a home care provider that services in Dumfries, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hope and Harmony Home Care, LLC is a home care provider that services in Dumfries, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Options for Senior America Prince William County is a home care provider that services in Dumfries, 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...
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...
For many, growing older or experiencing physical decline often brings with it the fear of drastic changes in lifestyle. At Home Helpers Home Care of Gainesville, VA, we believe that with the right support, nothing about...
At RAKEB HOME HEALTH CARE, LLC, we specialize in providing a comprehensive range of home health care services tailored to meet the unique needs of our clients.
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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.