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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:
Whether providing short-term assistance or long-term support, our team is committed to enhancing well-being and fostering peace of mind for both clients and their families.
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Heart Matters Home Health Care is dedicated to providing the best possible home care services for you and/or your loved ones. We staff licensed healthcare professionals to assist our clients with activities of daily...
At For Better Home Healthcare our commitment is to transform the way in-home care is experienced by blending compassion, excellence, and truly personalized support. Our mission is to help individuals live safely and...
Life moves in one direction – forward. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people, and their loved ones, emotionally and...
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...
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...
Compassionate In-Home Care Services for Your Loved Ones Whether it's companionship, personal care, or dementia support, we provide warm, reliable, and personalized care right in the comfort of home. Discover how our...
At Homewatch CareGivers of Chantilly, our philosophy is guided by a simple yet powerful principle: to provide the kind of care we would want for our own family. This commitment drives us to match clients with caregivers...
For over 50 years, Interim HealthCare has been personalizing care to meet the unique health needs of our clients, patients, and partners. Our team's standard of care is centered around HomeLife Enrichment, our unique...
To be the most trusted home care provider, known for exceptional service, outstanding caregivers, and a commitment to enhancing quality of life at home.
AESTAR Home Care provides compassionate in-home support, offering assistance with daily activities, personal care, mobility, meal preparation, medication reminders, and companionship. Their caregivers focus on dignity,...
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...
The Executive Home Care Mission We work in a unique industry with unique opportunities to provide meaningful improvement in seniors’ lives. We also realize that this comes with great responsibility.
Green Life Home Care, LLC is a home care provider that services Springfield, VA 22150. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with personal care and...
At Devoted Care, we understand that there’s no place like home. That’s why we provide compassionate, non-medical in-home care designed to help seniors and adults live safely, comfortably, and independently in the place...
A Place At Home – Reston provides compassionate, professional, and dependable in-home care for seniors and families in Reston, VA, and throughout the surrounding areas of Chantilly, VA | Sterling, VA | Herndon, VA |...
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...
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...
Assisting Hands of Loudoun provides personalized in-home care assistance empowering seniors to maintain their independence and quality of life while receiving support with daily living tasks.
Guiding Light Care is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are expert caregivers with an intimate understanding of our patients' and their families' needs, enabling us to customize programs to deliver proactive in-house care that improves the quality of life while maintaining...
Reliable and Personal care for families. Find expert long-term or short-term home health aides, from day-to-day companions to around-the-clock nursing care with Peace of Mind.
Dynamic Home Health Care is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
1st Americare, LLC is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our trained caregivers offer compassionate support with daily living activities, medication reminders, companionship, and more—all delivered with a deep commitment to respect, empathy, and excellence. At Bliss Home Health...
Godwin Home Healthcare is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Loving Angel's Health Care is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Prima Home Health, Inc. is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Why move to a facility when you can receive the same services in your home? Older adults want to live on their own terms, where they want to live and how they want to live. Autonomy, dignity and choice.
DO NOT CALL Stay at Home Care LLC is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
ABP Senior Home Care, Inc. is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sabah Home Care, LLC is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Angel Senior Home Care is a home care provider that services in Chantilly, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Home Care DMV, we started with a simple idea: to provide reliable and compassionate home health care services to those in need. Over the years, we have grown into a trusted provider of quality care, serving the needs...
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 Home Health Options Group Inc. (HHO) was formed to provide an aging population and others with diminished physical capabilities with an option to stay at home and receive non-medical assistance. We will provide...
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...
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...
At RAKEB HOME HEALTH CARE, LLC, we specialize in providing a comprehensive range of home health care services tailored to meet the unique needs of our clients.
Butters Home Health Care is a professional in-home care provider, assisting individuals and families who need one-on-one care of their loved ones. As a team of highly experienced, motivated, and dedicated associates,...
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...
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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.