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.
✔
I acknowledge and authorize
✔
I consent to the collection of my consumer health data.*
✔
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:
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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...
Capital City Nurses CHC- Local/DC is a home care provider that services in Laurel, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Jumotek Healthcare Services provides non-medical companionship in Bladensburg, Maryland, in the comfort of any place you call home. We employ compassion and tender loving care to provide care to the needs of the elderly...
Our team of skilled caregivers offers a range of services, including personal care, companionship, medication management, light housekeeping, and specialized care for chronic conditions or disabilities. Committed to...
Senior Helpers of Laurel, MD is a home care provider that services in Laurel, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Blessed Angels Home Healthcare Services extends a warm welcome to you our client and to your family and friends. Your medical treatment, safety and happiness are most important to us as we will do our best to answer any...
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Our Value We strive to provide the Best Quality Home Care. We Promote: Affordable High-Quality Health care A culture of Compassion and endurance Ethics and Integrity Cultural Awareness and Diversity
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At Adonai Family Healthcare LLC, we’re dedicated to delivering compassionate, comprehensive, and accessible healthcare to every family. Our community-focused approach provides personalized medical services for families...
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...
SHEKINAH LOVING CARE INC. is where we offer a comprehensive range of home health care services designed to meet the unique needs of each individual. Our dedicated team is committed to providing exceptional support and...
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Caring 4 You And Yours LLC Home Care is a trusted and compassionate provider of non-medical in-home care services designed to enhance the quality of life for individuals and their families.
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At Aveon Services, we believe true care goes beyond physical support—it's about fostering connections, promoting dignity, and restoring balance in challenging times. Our compassionate team offers personalized in-home care...
Home Instead® is a reliable source of home care for seniors in the Anne Arundel County area including Annapolis, Edgewater, Arnold, Severna Park, Pasadena, Crofton, Millersville, Odenton, Odenton. Services include...
Ellis House, LLC strives to be one of the leading providers of a wide range of quality care and services, recognized for enduring dedication providing innovative, professional and compassionate care to the communities we...
Options for Senior America - Gaithersburg, MD is a home care provider that services in Laurel, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Capital City Nurses - Columbia is a home care provider that services in Laurel, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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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Griswold Home Care for Anne Arundel & Queen Anne's Counties, MD is a home care provider that services in Laurel, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or...
Our Tender Hearts is committed to enhancing the quality of life and enriching minds by providing compassionate home care and healthcare education in the community
Founded in 1966, Interim HealthCare is the nation’s first home care company and a trusted provider of home healthcare, personal care and support, hospice care and medical staffing services.
QCC Home Health Care is a home care provider that services in Laurel, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Welcome to Pleasant Care and Nurse Staffing! Pleasant Care and Nurse Staffing is your local source for reliable care. Our company is proudly a part of the community in Maryland, Washington, D.C. and Virginia. We serve...
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...
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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.