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.
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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:
At Lyfetyme Home Care, we prioritize your well-being and comfort in your home, the place where you have experienced a Lyfetyme of great memories and milestones. Our team is dedicated to delivering professional and...
Here at Senior Helpers – Virginia Beach, we are a Veteran owned and operated home health care franchise located in Virginia Beach. We provide high quality personal and companion care to individuals in the comfort of their...
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...
Concierge Care in the Comfort of Your Home We are committed to delivering unparalleled home care services to the senior community throughout Virginia. Located in the heart of Virginia Beach, our mission is to Bring Joy...
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...
Restorative Care Senior Services is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Ease Home Care is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
our mission is simple yet profound: to provide dependable support and caring service in a family atmosphere. We believe that every individual deserves to age with dignity and independence within the familiar embrace of home.
Miss S Care: A Compassionate Senior Home Care Provider Entrust your aging loved one's home health care needs to Miss S Care in Hampton Roads, Virginia. We work with patients in the convenience of their homes and work...
CM Health Solutions is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Jewish Family Service of Tidewater is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cherished Home Services LLC accommodates seniors and dependents needing Skilled Nursing Services and non-medical assistance at home, with the option that most people prefer – to remain independent, comfortable, and safe...
Home Helpers is a trusted provider of compassionate in home care in over 600 communities across America. We give peace of mind to the families we help by tailoring our in home care services to each situation, and offering...
Quality Hands & Hearts Home Care is completely devoted to excellence in providing non-medical care to enhance and improve the quality of lives of those entrusted to our care with respect and dignity. We at Quality Hands &...
Heartland Home Health&hospice is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Deloris Home Health in Virginia Beach, Virginia provides comprehensive home health care services to residents in the area. Their offerings include skilled nursing care, physical therapy, occupational therapy, speech...
Caring for Your Homecare Services, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nothing is more important than helping people to live full, independent and dignified lives within the comfort of their own home. A Caring Hart is dedicated to providing the kind of non-medical in-home care that helps...
GreenLight HomeCare Services, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Beyond Believers LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are passionate about keeping elderly people safe and independent in their own home. We offer a variety of senior home-care services, so you can be sure we have the option that will work best for you. Since 1984,...
OUR MISSION: MED Staffing is committed to providing dedicated and compassionate professional care. Our Care plans are personalized to meet the specific needs of very individual who requires personal care and/or...
Bedrock at Home - Virginia Beach is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
K&K Home Health Cares 4 You, Inc. is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentle Hands Home Healthcare Services is a local Home Healthcare Company specializing in Private Duty, Companionship, and Medicaid Services in the Hampton Roads Area. Since 2008 we have continued to focus on the needs of...
Gentiva Hlth Serv VA Beach is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Loving Touch Home Care, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hope, Care & Love Home Healthcare Services, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
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...
At Interim HealthCare, our primary goal is simple. We are dedicated to Improving People's Lives In the Community We Love. As a matter of fact, it’s our mission statement! Proudly operating from five offices serving...
Tons of Love Home Care is committed to providing our clients and their families with the best service by focusing on the clients individual needs. Our compassionate care and support will enable clients to live safely in...
Val's Home Care, LLC 📍 900 Commonwealth Pl STE 200, Virginia Beach, VA 📞 757-966-8248 Welcome to Val's Home Care, LLC, where compassionate care meets the comfort of home. Located in the heart of Virginia Beach,...
Arcadia Health care provides Private Duty Health Care Workers in Virginia Beach, Norfolk, and Chesapeake areas. Arcadia is licensed, bonded, insured, and all workers have at least one year of experience. Complete...
Peace & Love Home Care LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
Reassurance Health Care LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Mission Adom Care At Home is committed to providing quality care to the elderly and the sick while they age comfortably in their homes and or recover from Illness and injury.
At M & D Healthcare, we understand the unique challenges that come with aging and the importance of tailored support to maintain independence and dignity. With years of experience and a compassionate approach, our team is...
It doesn’t matter if you’re here because you’re looking for help living independently, or if you want to make sure someone you love has the support they need to stay in their home. We believe there’s more to caring for...
Labor of Love Total Healthcare is a Service Disabled, Veteran Owned Small Business (SDVOSB), Small, Women and Minority (SWaM) certified company, established in Virginia in 2006. At Labor of Love we provide more than...
Hope IN-Home Care Inc is a home care provider that services in Virginia Beach, 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,...
Patient Aide Home Care is a home care provider that services in Virginia Beach, 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...
At FirstLight, we understand your loved one deserves more than having someone who simply keeps them company. They deserve a caregiver who is passionate about helping them have their best day, every day. That’s why we do...
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...
We’re Proactive To Meet Your Needs Your family won’t get lost in the shuffle with us. Some agencies simply react to calls from clients rather than anticipating your needs in advance. We begin by reviewing your needs...
Changing Tides Home Care supports your loved one’s independence and well-being. We work closely with you to develop an individualized care plan, and to match you with caregivers who are well suited to your loved one’s...
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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.