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.*
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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:
At FirstLight Home Care, we envision a world in which all adults may age with comfort, dignity and independence in the place they call home. We exist to help people have their best day, every day. Our mission is to...
Senior Helpers of Stafford, VA is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We are committed to offering services that cater to each client’s unique needs. With our client-centered service approach, we enable them to live independently in their own homes. Our compassionate caregivers do their...
Home Helpers® Home Care is a home healthcare service that provides top quality in-home care. Our Cared-4℠ program is a holistic approach to meet the four primary areas of need, helping your loved one stay safe and...
Whether you need assistance with daily tasks, require specialized care for a chronic condition, or recover from an illness or injury, Cora Healthcare Services is here to help. We believe in treating our clients with...
Comfort Home Care Services has been a proud member of the local Stafford, Virginia community since 2010. We provide the most exceptional level of care to your loved ones by treating them as our own. We strive to enhance...
Abide Home Care LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Beth-El Home Health Services of Stafford, VA is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
First Ally Home Care, LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Lloyds Homecare Services LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Aldrich Care Solutions, LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Care with Dignity at Home, LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Let Home Helpers & Direct Link of Stafford, VA Create a Customized Home Care Plan to Fit Your Lifestyle! Live life your way in the comfort of home with Home Helpers of Stafford! Whether you’re a family caregiver or...
Alternative Living Residences LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Trusted Hands Home Care, LLC, VA is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bethel Healthcare Services, LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Unique Trust Healthcare brings together compassionate, dynamic, and sympathetic individuals to work in the service of aiding the injured, disabled, sick, and aged live regular lives. Each one of our staff has undergone a...
Licensed in the state of Virginia, Kharis Care Partners is a home care agency with highly skilled professionals who are committed to providing quality care always. Our purpose is to give the finest care to our clients and...
Godaelli Healthcare Services, LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
EveryCare Nursing Services, LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We prioritize dignity, independence, and quality of life, ensuring that every individual receives the best possible care in a safe and supportive environment.
Lifemate Home Healthcare, LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We believe every Senior deserves to age comfortably at home at an affordable cost. Unlimited Care 4 Home Health Care is a family owned, women owned, and minority owned Home Health Care agency originating in Stafford,...
Americare Health, LLC is a home care provider that services in Stafford, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Absolute Home Healthcare focuses on delivering compassionate, client-centered care tailored to meet each individual's unique needs. Services include assistance with daily living activities, medication management, and...
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 serve this incredible nation and its people. To empower home health to deliver quality patient care to enhance the health of our communities. To provide the best service with a compassionate and caring approach. To...
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.