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:
Raquel Micit, owner of Amada Senior Care Silver Spring, understands that choosing the right in-home care company for a senior loved one is a life event that most families are not prepared for. As a senior care advocate...
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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...
Staffing on the Go was created to solve the complicated nature of hiring quality talent and finding quality jobs in the medical field. Our experienced staff goes through the critical process of verifying every job &...
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...
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...
Prospect Nursing and Home Care Services is a trusted provider of compassionate home health and professional healthcare staffing solutions in Frederick, MD. We proudly serve patients and clients of all ages — from babies...
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...
Our homecare staff provide personalized support for daily needs while also offering meaningful companionship. At Dusk To Dawn, we strive to make life easier and more comfortable for every patient we serve. We deliver many...
At Homewatch Caregivers of Potomac, we understand that deciding to seek in-home care for a loved one is never easy. It's a choice filled with emotion, hope, and the desire to provide the best for those who have always...
Options Home Care of Gaithersburg, 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...
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...
Their mission is to deliver professional, compassionate care and rehabilitation for individuals with acute, chronic, or terminal conditions, while their vision is to become a leading provider of innovative, home-based...
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...
Advanced Nursing + Home Support is committed to providing expert and compassionate care to every client. By engaging the highest quality health care professionals, and by providing exceptional service at every level, we...
Wendy and Todd Johnson opened the Senior Helpers Silver Spring office in 2007 because of their passion for helping others by delivering the best possible in-home care to seniors throughout the Silver Spring community....
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...
Philia is a Home Care Agency in Washington, DC providing senior and child care services. Our focus goes beyond our clients’ safety and health as we incorporate activities into the care plan to address their emotional...
Hajmoud Homecare Health Agency LLC is a home care provider that services Upper Marlboro, MD 20772. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are a dedicated healthcare provider committed to delivering exceptional care to those in need. Our goal is to enhance the lives of our patients and their families by providing comfort, support, and dignity. Based on...
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...
Capital City Nurses of Chevy Chase, 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...
1. A care team led by a Registered Nurse that develops and implements a personalized care plan for each client 2. Experienced, compassionate, and highly trained caregivers 3. On-going training and Development for all...
Caring with compassion and dedication Welcome to Beulah Home Services, Inc. Beulah Home Services Inc. was born out of a desire to provide meaningful support to the elderly who need help with the basic Activities of...
Comprehensive Home Health Agency 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...
Heart For Life Healthcare, offers a variety of care related services, to assist you while you recuperate from illness, injury or surgical procedure. In addition to our skilled nursing care, personal care,companion...
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...
We are an affordable, compassionate choice for family caregivers considering nursing homes or assisted living facilities, and our attentive, dependable caregivers can offer comfort and relief. We offer customized in-home...
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,...
Sc Home Health Care Service 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...
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...
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...
Caring for a family member can be challenging. At Compassionate Caregivers of Maryland, we strive to deliver just the right care for your loved ones to be safe and healthy, and to be a reliable partner you can turn to for...
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...
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...
Care for You, Inc.®, created in 1996, is family owned and operated. Whether the need is temporary or on-going, we do whatever is necessary to keep individuals in their homes. Home is where the person lives –...
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...
At Comfort Care Partners, we provide reliable and affordable non-medical home health care services to our clients within the DMV area. Our staff guarantees personalized attention to all of your home health care related...
Unity Health Management, 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...
Assisted Care Consultants 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...
Our mission is to provide an individualized plan of care and to meet the physical and emotional needs of client/family. We reflect a spirit and philosophy of caring to ensure comfort, dignity, and quality of life for each...
Graceful Hand Home Healthcare, 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...
Riderwood Village, 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...
Adventist Hme Hlth Servs 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'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.