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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:
Senior Helpers Baltimore is the premier provider of in-home senior care. We offer tailored home care services ranging from companion care for seniors who need daily assistance to in-depth specialized care for those with...
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...
Care and Beyond Homecare is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Best Care Home Care is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Located in Upper Marlboro, Hope Homecare Incorporated is dedicated to providing compassionate and reliable in-home care services to those in need. Specializing in non-skilled care, our team offers a range of supportive...
Welcome to Cogzwell Health Services Inc, your trusted partner in non-medical home health care in Germantown, MD. We specialize in providing compassionate and reliable care services tailored to meet the unique needs of...
At jomay homecare, our nurses and caregivers are our greatest assets. we pride ourselves in providing the highest quality care vital to the health and well-being of our patients. our nurses and caregivers who chose the...
C J Healthcare Services provides compassionate, professional homecare support tailored to meet the individual needs of each client. Specializing in elderly and disability care, our skilled caregivers assist with daily...
Your home provides comfort and security like no other place on earth. Our mission is to assist and help you manage your personal and medical needs in comfort of your home.
A Homemade Plan of Lanham, MD is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Senior Helpers of Laurel, MD is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Comfort Home Care LLC, provides in-home care, according to your schedule, your needs, and your individual personality, or that of a loved one for whom you may be primarily responsible. Comfort Home care is unique because...
Serving You Home Care is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Options for Senior America - Gaithersburg, MD is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Dominion Home Healthcare Services, we provide exceptional care and support through personalized in-home skilled nursing care. Our team of compassionate and skilled professionals is committed to ensuring your health and...
ClinCare Nursing Services is a licensed home care agency. We are committed to providing compassionate and confidential nursing care that meets the client’s right where they are. Our skilled nursing and non-skilled home...
Vicky Health Care LLC, based in Silver Spring, MD, provides compassionate non-medical in-home care services. Our team is dedicated to supporting seniors and individuals with disabilities, promoting independence, dignity,...
Holistic Health Care Services Inc is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aasurance Nursing Services LLC is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Medstar Health VNA, Inc is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Chacha Impact Healthcare Service Llc is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Sodalite Healthcare LLC is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Elite Home Care Solutions is an all-around home care services provider and home healthcare agency based in Beltsville MD; committed to providing quality home healthcare to the aged, ill, or disabled in Montgomery County,...
Americare Alliance of Maryland is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
J and J Medical Services, Inc is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Beamcare Home Health is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We understand that choosing a home health care provider can be a difficult decision. That's why we are committed to providing the highest level of care and support to our clients and their families. Our team of skilled...
Maximum Health Care Services, Llc is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Amazing Homecare Health Services is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Expertcare Services LLC, your trusted partner in non-medical in-home care. Based in the heart of Beltsville, Maryland, our mission is to provide exceptional care and support to individuals who need assistance...
First Choice Quality Healthcare is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Continium Health Care Services LLC, MD is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Excel Health Care Services, Inc is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission at Heart to Heart Health LLC is to provide exceptional home care services with compassion, integrity, and professionalism. We strive to create a supportive and nurturing environment where our clients feel...
DUPLICATE -Elite Home Care Solutions LLC is a home care provider that services in Beltsville, MD. 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...
About us APH Dependable Health Care LLC provides non-medical home health aide and companion care services to seniors, elderly, mentally challenged and physically challenged adults. Through coordinated care and support...
DUPLICATE - Elite Home Care Solutions is a home care provider that services in Beltsville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Interim HealthCare of Bowie, Maryland, we know how important it is to be in a comfortable, familiar environment. We all value our independence, however, sometimes the best way to maintain our autonomy, or preserve 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.