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:
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Independent Living Home care is a family-owned, private-duty home care company. Whether your dear loved ones are recovering from an injury or dealing with a serious disability, we provide relaxing recovery and ongoing...
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...
Homewatch CareGivers of Woodbridge, VA is a home care provider that services in Manassas, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
At Safenexhomecare.net, we are dedicated to providing exceptional home care services tailored to the unique needs of the elderly in Falls Church and Woodbridge. Our experienced caregivers work from the heart to enhance...
Always Family Homecare - Vienna, VA is a home care provider that services in Manassas, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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,...
Prince William Hosp HM Hlth is a home care provider that services in Manassas, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Sweet Home Health Services, LLC is a home care provider that services in Manassas, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Right at Home - Manassas, VA is a home care provider that services in Manassas, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kindalle Home Healthcare, LLC is a home care provider that services in Manassas, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
SuBon Home Care is a provider of affordable home care in Manassas, Virginia, for the elderly and people with physical conditions and cognitive disabilities who prefer to stay in their own homes rather than transfer to...
Nova Home Care is a home care provider that services in Manassas, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Lifeline Home Care, Inc. is a home care provider that services in Manassas, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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America's Home Health Care, Inc. is a home care provider that services in Manassas, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With home care services, our office can provide personal care plans through an in-home evaluation and interviews between the client, family and the ComForCare team to help determine the best plan of action for the...
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We providing affordable, high-quality service delivered with kindness and dedication. The deliverance of our services is in compliance with all government standards, rules and regulations.
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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...
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At Awl's Personal Care Service (AWLPCS), we help people live full, independent and dignified lives within the comfort of their own homes. We are dedicated to providing in-home care that improves our client's lives and...
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Caring Hearts Homecare will work closely with your family to develop a custom care plan and find the most suitable solutions. As a bonded and insured home healthcare agency, we are here to serve you at Prince William,...
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Options for Senior America Prince William County is a home care provider that services in Manassas, 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...
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...
At Hope and Recovery Care, we are ready and eager to serve your loved ones with a team of professionals who have expertise in patient care and health recovery. We specialize in nursing care, personal care, and recovery...
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...
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...
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.