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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:
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Best Care Home Care is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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2nd Family - Eldersburg is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Amada, quality care is our priority. We look for ways to make simple, everyday tasks special. Amada’s in-home caregivers not only take care of daily essentials like cooking, cleaning and grocery shopping, but they also...
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Allset Home Health is a non-medical in-home care agency based in Maryland, dedicated to providing compassionate and reliable support for individuals needing assistance with daily living activities. Their services include...
When the time comes that extra care is required, whether due to age or health condition, many people prefer the familiarity and comfort of their own home. At Homewatch CareGivers®, we believe that good care should not...
What Makes SYNERGY Different? Reliability SYNERGY HomeCare's Care Team can be relied upon to be at their assigned shift as scheduled. SYNERGY HomeCare utilizes a telephony system allowing us to know when our caregiver...
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Nest & Care LLC, MD is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Rock of Ages Health Care is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kabir Home Care is a non-medical home care agency that covers Fairfax, VA. We are dedicated to providing personalized, compassionate care to seniors and individuals with disabilities who wish to maintain their...
About us Meet our founder Henrietta Jones RN is the founder and Executive Director of Hope Medical Staffing and Medical Consult with 23 years of experience in healthcare in homecare, mental health and hospital. She is...
Lifematters was founded with a single mission in mind – to dramatically improve the lives of clients by helping them manage their personal and health care needs in the comfort and privacy of their own homes.
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Care Personnel Healthcare, Inc. is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Empower individuals and enhance their quality of life by providing exceptional homecare services. We are dedicated to delivering compassionate, personalized, and professional care that promotes independence and well-being...
Amedisys Home Health Care is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Alliance Staffing Agency, Llc is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Precious Senior Home Care, Llc is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angel Of Care Home Health Services is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Good Hope Health Services is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At MyPillar Healthcare, we place a high priority on customer service and recognize that different customers have different needs. We have the experience and flexibility to truly understand a client’s needs, develop a care...
Automatic Nursing Care Services, Inc is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angels Of Mercy Home Healthcare Services, LLC is dedicated to providing compassionate, high-quality, and personalized home healthcare services to our clients. Our mission is to enhance the well-being and quality of life...
Montgomery Home Care Services, has proudly provided exceptional private duty care to the elderly population of Montgomery County Maryland for almost a decade. Our friendly staff brings more than 35 years of eldercare...
Here at Amaray Care, we offer quality services in the field of nursing and nutritional guidance, as well as geriatric health care management services. We offer these services through a network of healthcare providers on a...
Choral Healthcare Services Inc - Silver Spring is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Companion & Nursing Homecare is a home care provider that services in Silver Spring, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a licensed non-medical home Care and staffing company that provides services to patients in the state of Maryland. Your family and personal health is our priority. We are a Home care agency that provides skilled...
At Genesis Homecare Services, we are committed to providing high-quality, non-medical in-home care services that prioritize comfort, dignity, and independence. Our mission is to support individuals in leading fulfilling...
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...
Gloves Health Care Services LLC provides comprehensive home health care services that address our clients’ overall health and well-being. We have a multidisciplinary team of professionals dedicated to providing...
At Freedom Home Care, we are dedicated to providing the highest quality of care in the Home Care Profession. We are a bonded and insured non-medical home care agency serving the Anne Arundel County Area. We provide...
We are a premium home care agency with sophisticated and mature caregivers who can relate to clients. We match caregivers and clients with complementary personalities and similar interests. The result is service that...
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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.