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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
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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:
ARAA Home Care, LLC, we are proud to serve the community with home care services that are tailored to the needs of medically fragile persons and their families. We work together as a team to give every patient a healthy...
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...
A Homemade Plan is a hardworking and caring home care company that is dedicated to its patients, clients, care providers, and community. We are a locally owned and operated company based in Maryland. We help those who...
At GAVA Healthcare, we are a licensed home care agency serving Maryland. As a locally owned family business, we are dedicated to providing compassionate and personalized care services to people of all ages. With a deep...
Options For Senior America Corp. started providing home care services in late 1989 to the residents of the Washington, DC metropolitan area. What started as a handful of customers grew substantially due to the personal...
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.
Are you looking for a healthcare professional to care for a loved one or to fill in the vacant positions in your facility? BZED Home Healthcare and Staffing provides both home health care and healthcare staffing in Owings...
We understand that the first step in determining what type of care is most appropriate is to first meet with a client for a complimentary in-home assessment and visit. Our goal is to help you experience the least...
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...
Best Care Home Care is a home care provider that services in Pikesville, 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...
2nd Family - Eldersburg is a home care provider that services in Pikesville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Loving Care Home Services is a home care provider that services in Pikesville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Trustworthy Staffing Solutions is a Residential Service Care Agency established and designed to provide quality, cost effective in-home nursing and personal care for the adult and pediatric medically impaired. Our goal...
Home Health Care Services is a home care provider that services in Pikesville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Kennedy Care DC, LLC is a home care provider that services in Pikesville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
All About You Health Care Services, Inc is a home care provider that services in Pikesville, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Superior In Home Care, LLC is dedicated to providing in and out of home care to senior and others who need help with activities of daily living. Our goal is to allow people to stay in their own homes versus seeking other...
Are you in need of a caregiver or nurses/aides for your loved one or yourself, look no further, at JAMHURI HEALTHCARE SERVICES located in pikesville MD ,we provide care for all, young and old, we will do more than just...
Gandhi Home Health Care envisions to be a leading home health care provider. Having a well-respected reputation in the industry, we will meet each of your expectation as well as do our best to maximize beneficial health...
Whether you are recovering from an illness or surgery, or needing a safe place to retire, there’s no place that can be warmer, more familiar, and more intimate than your own home. Because of this, we aim to satisfy your...
At Straight From the Heart Home Care Solutions, we believe that every individual deserves to receive high-quality, compassionate home health care. We are committed to treating our clients with respect, dignity, and...
Dignity With Care dedicates itself to providing various levels of professional nursing service whenever and wherever you want service. Whether you want in-home personal aide service a few hours per week, 24 hours per day,...
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,...
At Royal Gem Home Health Care LLC, we believe that every individual deserves to receive high-quality, compassionate home care services. We are committed to treating our clients with respect, dignity, and kindness and to...
Most patients and seniors prefer to recover or age gracefully in the place where they feel most comfortable — their home. That is why at Pacesetter Healthcare, we want to make quality life at home possible for the elderly...
August Nursing And Therapy Services is a home care provider that services in Pikesville, 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...
To improve quality of life for those we serve through the delivery of clinical excellence, extraordinary service and compassionate care, while being recognized as the leader in home health.
Kendall Care is committed to providing the highest quality of care to our clients. Our goal is to provide individualized care in a way that promotes dignity, independence and an optimal quality of life. We ensure the...
We at Griswold Home Care Referral Service realize that every home-care situation is unique and that having the correct type and amount of care for your loved one is what provides our clients with peace of mind. Whether it...
Our mission and values are directly impacted by personal experience. Our mom, unfortunately, left us too soon as a result of an illness that none of us were prepared for. We didn’t have the support or information needed...
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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.