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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:
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...
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...
My Privilege Home Care, LLC is a home care provider that services in Sterling, 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...
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...
Premium Home Health Care is owned and operated by true healthcare advocates along with a team of exceptional talents who deeply understand not only what it means to be a caregiver but most importantly, to be a care...
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...
Our mission is to provide compassionate, personalized care to individuals who need assistance with daily living activities. We understand that aging, illness, or disability can be challenging, and our goal is to help our...
Companion care services are of the utmost importance to the physical and mental health and wellness of your aging loved one. In the later stages of life it can be more difficult to make the social connections that add...
Nova DMV Nurses and Caregivers, located at 42882 Truro Parish Drive, Suite 206, Ashburn, VA 20148, is a non-medical home care agency dedicated to providing compassionate and professional caregiving services to clients in...
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...
SYNERGY HomeCare of Dulles, VA is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Helpers Home Care of Northern VA is more than an in-home health care agency – we help make life easier and more enjoyable for you and your family. We’re a locally owned, trusted provider of quality, compassionate...
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 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...
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.
Hi-Pointe Care Solutions is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Acti-Kare is a leading in-home care provider across the United States. For over a decade, our locations have personalized in-home care services around you, your loved one and the family. This allows you or your loved one...
Blossom Home Health Care is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
First Choice Home Care, LLC is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Dove Home Health Care, LLC is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Advance Home Health Care, LLC is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
To provide quality home care by focusing on individual needs and bringing attentiveness to the unique lifestyle of each person. You can rest assured that our medically-trained and caring staff nurtures your loved ones,...
Safe and Happy : That is what we all want to be. At Senior Care Safe at Home, our mission is to enable all adults to remain in the most desirable place of all: their own homes. Our goal is to offer the help and...
Gift of Help Home Health Care, LLC is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Radiocw-Healthcare provides superior quality health care services to individual clients and their families, as well as to other healthcare organizations in need of supplemental staffing. Our priority is to provide...
At Cardinal Home Care (formerly NOVA Vets Connect), we provide compassionate and professional home care services for seniors and veterans of all physical conditions and cognitive abilities. If you or a loved one is...
Talem Home Care - Sterling, VA is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Five Star Home Health Care provides assistance with activities of daily living enabling you to stay at home and avoid nursing home placement. Services include bathing, dressing, grooming, ambulation assistance, fall...
Talin Home Healthcare is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Care Angels, we provide quality Home Health Care service to individuals with developmental disabilities so they can function as independently as their capabilities will allow; live their own lives and make their own...
Living on your own doesn’t have to mean living alone. Allegiance is a private, locally owned home care company that offers both live in and hourly options to meet your needs individually. We are able to provide flexible...
Karma Home Health Care, LLC is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Becky Healthcare LLC, VA, our mission is to redefine healthcare delivery by prioritizing patient-centered care, innovation, and community engagement. We are dedicated to enhancing the well-being of our patients through...
Prime Services LLC is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Novena Healthcare, LLC is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
True Passion Home Care, LLC is incorporated by the Virginia State Corporation Commission as a limited liability company owned and family owned agency. It is a home care agency that is located in Sterling, VA. We are an...
Angels Home Health Care, LLC is a home care provider that services in Sterling, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Northern Virginia Home Care believes that everyone is entitled to make decisions about their healthcare; it’s your right to choose, choose wisely. A Northern Virginia Home Care Staff member is available 24 hours a day,...
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...
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,...
As the premier home care agency in Sterling, Loudoun and Western Fairfax, our services give your loved ones the same freedom and independence they have now. That’s what Homewatch CareGivers of Loudoun does, and we do it...
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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.