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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:
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...
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...
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...
Adonai Home Care Services is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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 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...
Home Helpers Home Care of Springfield, VA is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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.
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...
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...
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...
Quality caregivers and medical staffing solutions in Fairfax County At BrightStar Care of VA – Reston, owned by Robert and Kerry Massie, our home care agency provides quality home care, caregivers, and medical staffing...
Care isn’t just what we do, it’s who we are! Our compassionate caregivers and the families we serve are our number one priority. We go above and beyond to ensure every client’s needs are met. We are dedicated to...
SYNERGY HomeCare of Fairfax, VA is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home - Fairfax, VA is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
JSA HomeCare, Inc. is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Options for Senior America - Central Fairfax County is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Jna Home Health Solutions, Llc is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Allied Health Care, LLC is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We know from first-hand experience with our parents, in-laws and children, how stressful both caregiving to those that need it, and picking a quality home care provider, can be. We are here to help with the worry, fear...
Love to Care, LLC is a committed home care service agency dedicated to providing compassionate and high-quality care in the comfort of your own home. We know how important it is for you to maintain your independence in...
Inova Vna Home Health is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Pro Healthcare Servicing Llc is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
OOB Accessible Home Health Care of Northern Virginia is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
HomeCentris Healthcare is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Shana Home Care is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sheme Home Healthcare Agency, Inc is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Novena Healthcare Virginia is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Life Matters is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
J&C Healthcare focuses on health promotion through medicine, nursing care, care management, and research. We achieve excellence in patient care through a patient/family-centered approach. Being compassionate, honest, and...
A2Z Home Health Care is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
I-CARE, Inc. was established in 1993 because we Care About Restoring Excellence in health care. We continue to accomplish this goal by successfully staffing home health agencies, outpatient centers, nursing facilities,...
Shana Home Care, is not only our name, but it stands as our way of service. We bring safe, loving, and caring services to those that desire to have a nursing home setting and treatment, in the comfort of their own home....
Universal Healthcare Services, Llc is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
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...
Dignity Home Care of VA is a home care provider that services in Fairfax, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ElderOptions Senior Care is a family-owned and operated business dedicated to making in-home living safe and comfortable for aging adults — and worry-free for their families. At ElderOptions, providing reliable,...
Home Caregivers provides non-medical home care services to individuals in the comfort of their own home. We also serve as a resource company for you, your loved ones, or other persons involved in your support and...
Mint Home Care is a veteran owned agency. Do you need someone to assist you while taking care of your family members? Or you need to organize transportation to the hospital and back? Mint Home Care Providers is a bonded...
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...
Our clients love our expanded services – all with the same level of high touch service, responsiveness and attention-to-detail you’ve come to depend on and the reliability of a single care coordinator managing all your...
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.