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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.
✔
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:
The agency was established in Chesapeake, in 2002 by two Tidewater Community College graduate registered nurses employed as skilled nurses. Our mission is to provide "dedicated and caring" home care services for those...
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...
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
Harmony Touch Of Care strives to provide the best care for you and your loved ones in the comfort of your own homes. It is our goal to make your lives better and simple.
Bon Secours Home Care is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Simply Love New Beginning, Inc is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
1824 Home Health Care, Inc. is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elated Family Healthcare, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Beautiful A&T Home Care LLC Compassionate Care, Comfort & Independence Location: Virginia, USA Industry: Home Health Care / Non-Medical Personal Care Services: In-Home Care, Personal Assistance, Companionship, Respite...
Open Hands Home Health is a compassionate in-home care company dedicated to enhancing the quality of life for seniors and individuals with disabilities. They provide personalized care services, including assistance with...
Cencare Home Health Solutions LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tricities Home Services is a small Veteran Woman Owned Minority business established in 2011 as a response to the lack of compassionate home health care. Our highly trained staff works 24 hours a day to serve the families...
DeVoted Hands Healthcare, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
One Touch Priority Home Health Care Llc is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
To provide services and support that allow our clients to remain as independent as possible in their homes or residences while enabling a quality of life for our clients and their families which cannot be achieved on...
Irene's Home Health Care is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nurturing solution homecare INC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Family Care Senior Solutions is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
W.H.E.E. Promise LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Uniquely Us Home Health Care, LLC of Portsmouth, VA is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
A Higher Calling, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elkhart Home Health Care, VA is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Saved With Amazing Grace Home Care Services, Inc. is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aspiration in Life Home Care, LLC aims to provide compassionate and professional home care services to residents in Virginia (VA). With a commitment to enhancing the quality of life for clients, the agency focuses on...
Scott's Family Healthcare LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Williams Faith And Trust Home Healthcare, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Home Health Care, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
We are a service that provides care for the elderly and handicapped 24/7 and all legal holidays.in the privacy of your home or facility.We focus on the need of our patients and try to design a...
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...
The agency was established in Chesapeake, in 2002 by two Tidewater Community College graduate registered nurses employed as skilled nurses. Our mission is to provide "dedicated and caring" home care services for those...
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...
We proudly provide non-medical home care services to individuals with disabilities, injuries, difficulties with mobility, or illnesses. We are composed of highly trained and competent staff members who are dedicated and...
Harmony Touch Of Care strives to provide the best care for you and your loved ones in the comfort of your own homes. It is our goal to make your lives better and simple.
Bon Secours Home Care is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Simply Love New Beginning, Inc is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
1824 Home Health Care, Inc. is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elated Family Healthcare, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Beautiful A&T Home Care LLC Compassionate Care, Comfort & Independence Location: Virginia, USA Industry: Home Health Care / Non-Medical Personal Care Services: In-Home Care, Personal Assistance, Companionship, Respite...
Open Hands Home Health is a compassionate in-home care company dedicated to enhancing the quality of life for seniors and individuals with disabilities. They provide personalized care services, including assistance with...
Cencare Home Health Solutions LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Tricities Home Services is a small Veteran Woman Owned Minority business established in 2011 as a response to the lack of compassionate home health care. Our highly trained staff works 24 hours a day to serve the families...
DeVoted Hands Healthcare, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
One Touch Priority Home Health Care Llc is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
To provide services and support that allow our clients to remain as independent as possible in their homes or residences while enabling a quality of life for our clients and their families which cannot be achieved on...
Irene's Home Health Care is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nurturing solution homecare INC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Family Care Senior Solutions is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
W.H.E.E. Promise LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Uniquely Us Home Health Care, LLC of Portsmouth, VA is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
A Higher Calling, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elkhart Home Health Care, VA is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Saved With Amazing Grace Home Care Services, Inc. is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aspiration in Life Home Care, LLC aims to provide compassionate and professional home care services to residents in Virginia (VA). With a commitment to enhancing the quality of life for clients, the agency focuses on...
Scott's Family Healthcare LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Williams Faith And Trust Home Healthcare, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Premier Home Health Care, LLC is a home care provider that services in Portsmouth, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
We are a service that provides care for the elderly and handicapped 24/7 and all legal holidays.in the privacy of your home or facility.We focus on the need of our patients and try to design a...
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...
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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.