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:
Yad Lae Zeerah is a dedicated health care provider committed to offering affordable and comprehensive care solutions. Our mission is to ensure that high-quality health care services are accessible to all, regardless of...
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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...
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Senior Care Venture Providers LLC is a home healthcare agency in Gaithersburg, Maryland. Our agency was established to provide skilled and non-skilled care to patients in the comfort of their own homes. This way, we can...
At Golden Heart Healthcare Services, our mission is to deliver exceptional, compassionate, and personalized healthcare solutions that enhance the quality of life for individuals and families in our community.
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 Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our vision Is to prioritize patient safety and training, tailoring our services to unique needs and offering 24/7 assistance. Our goal is to improve quality of life and promote independence, dignity, and peace of mind.
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Shiloh Healthcare, LLC (Shiloh) is a Maryland State LLC based in Frederick, Maryland. Shiloh Healthcare provides dedicated, committed, and tailored sterling healthcare services for our clients at the comfort and pleasure...
Best Care Home Care is a home care provider that services in Gaithersburg, 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 Gaithersburg, 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 Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Noble Healthcare Services is a home care provider that services Laurel, MD 20708 and surrounding areas. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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...
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...
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...
Senior Helpers Rockville is committed to delivering the best possible in-home care to seniors in Montgomery County. Our top notch caregivers have a passion to serve you or your loved by providing companionship and...
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 &...
MISSION Our Mission is to deliver compassionate, quality, community-based home care and to provide healthcare staffing services to a wide range of facilities when care outside the home is needed. OUR VISION Our...
Care For Me Home Care Services is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our passion at Community Angels Nursing Services is to deliver the highest possible home care and first-class customer service to all without any discrimination. We are passionate about the quality of care we provide, and...
Lovable & Delight Home Care - Gaithersburg, MD is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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New Era Care Health Services, MD (dupe Account) is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
New Era Care LLC cares about your well-being more than anything else. We understand how taxing it could get to handle activities and other basic needs by yourself. This realization has led to us providing top-notch...
Visiting Angels is America's choice in homecare. We are very well known and respected for the quality of care we provide. We are loved by our clients for our caring, trained, screened and qualified caregivers. We are...
Comfi-Kare Homecare offers personalized home care assistance to meet the individual needs of older adults. We proudly assist senior adults with injuries, specific medical conditions, or who need assistance with daily...
Affectionate Touch Home Care Llc is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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My name is Mirza Donegan and I’m the Director of the Griswold Home Care of Aspen Hill Wheaton here in Maryland. Prior to Griswold Home Care, I was the marketing director at the North Bethesda Transportation Center. I was...
Care Plus Home Services is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Griswold Home Care for Aspen Hill-Wheaton, MD is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
The aim of Providence Staffing Agency (PSA), is to provide personalized, nurturing and attentive care to seniors in the comfort of their homes, day services programs and group homes. We realize that most seniors have a...
Interim HealthCare of Gaithersburg, MD is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Amazing Home Health Care, we believe that every individual deserves compassionate and personalized care that meets their unique needs and preferences. Our mission is to provide exceptional in-home care services that...
For over 30 years, Griswold Home Care has been referring the best Caregivers. We only refer Professional Caregivers that pass our stringent “CareAssure Screening System”. For your peace of mind, all of our Caregivers have...
Maryland Home Health Llc is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Nurses On Call - Gaithersburg is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
VICTORY HOME HEALTH CARE is licensed home Care Agency to provide non medical nursing services . VHHC is a fast growing provider of Home Care Services that enables adolescents and adults to be cared for in their home...
Blessing Home Healthcare Services Inc is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Shepherd Health Services, Inc. - MD is a home care provider that services in Gaithersburg, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mbl Associates is a home care provider that services in Gaithersburg, 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...
At NN Homehealth Service, we believe that home is the best place for your loved one to receive care. Partnering with families to provide compassionate care for those who matter most. Our goal is to provide our clients...
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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.