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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:
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...
Allied Nursing Services is a dedicated healthcare provider focused on delivering high-quality nursing care and support to patients in various settings, including homes, hospitals, and long-term care facilities.
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...
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...
Our goal is to help our clients regain their independence. To enable our clients to perform their activities of daily living without assistance as quickly as possible. We provide services that focus on improving your...
Best Care Home Care is a home care provider that services in Damascus, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
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...
2nd Family - Eldersburg is a home care provider that services in Damascus, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to enrich every lives we encounter, we are dedicated to providing experienced caregivers, quality patient care with relentless attention to clinical excellence, patient safety and consistency to ensure...
Care For Me Home Care Services is a home care provider that services in Damascus, 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...
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.
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...
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,...
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...
Senior Helpers - Frederick, MD is a home care provider that services in Damascus, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Dewis Healthcare LLC, we are a non-medical home care agency based in Upper Marlboro, Maryland, dedicated to enhancing the quality of life for individuals in our community. Our compassionate caregivers provide...
Options for Senior America - Gaithersburg, MD is a home care provider that services in Damascus, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care and Beyond Homecare is a home care provider that services in Damascus, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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 &...
Better Life Home Care Services Llc is a home care provider that services in Damascus, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Better Life Home Care Services Llc is a home care provider that services in Damascus, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our mission is to improve our clients’ and their families’ overall quality of life and health. We do this by offering our services with their health, safety, and comfort in mind at all times.
Victory Home Care. Leading Home Health Care In Maryland. Victory Home Care is dedicated to offering in-home care in Maryland. With a clinically focused approach, we are here to provide the best quality care to our...
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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.