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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About us Meet our founder Henrietta Jones RN is the founder and Executive Director of Hope Medical Staffing and Medical Consult with 23 years of experience in healthcare in homecare, mental health and hospital. She is...
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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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Capital City Nurses CHC- Local/DC is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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We are a licensed non-medical home Care and staffing company that provides services to patients in the state of Maryland. Your family and personal health is our priority. We are a Home care agency that provides skilled...
At Senior Helpers, we are here to help anyway we can. No matter how big or how small the task. We are licensed, bonded and insured and have screened and continuously trained caregivers that are immediately available to...
A Homemade Plan of Lanham, MD is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Mercy Health Services is a home care provider that services Prince George's Montgomery, Baltimore, Baltimore (city), Anne Arundel and Howard, MD. Home care services allow seniors to remain safely in their own home while...
Cornerstone Nursing Care is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gladden Nursing Care is licensed by the Maryland Department of Health as a Residential Service Agency (RSA) since 2003. We are a premium provider of personal, nursing, and respite care. We serve the senior population and...
Our Core Belief Our patients and residents are the centers of our care and services. Our employees are the bridge between Beta Healthcare & Staffing Solutions Inc and our patients/residents. They are our most valuable...
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Hajmoud Homecare Health Agency LLC is a home care provider that services Upper Marlboro, MD 20772. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Who we are Grace Line Nursing is a client-oriented agency guided by the business values of service excellence, integrity, and compassion. We are your trusted partner in delivering ideal healthcare staffing and nursing...
Home Call of Prince George County is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
We understand the difficulties you may face when living independently and recovering at home. That is why we commit ourselves in providing convenient healthcare services in Maryland, so you can heal safely in a...
Supreme Healthcare Services is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Cornerstone Care Nursing is a provider of healthcare services to the clients in the comfort of their homes. As our company has grown, we have maintained a commitment to high performance and unsurpassed knowledge about the...
Distinctive Home Care Inc - Largo is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Abundant Support and Care, LLC is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Anchor Home Health Services, Llc is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Golden Manor Residential Services is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Gosheni Healthcare Services is a home care provider that services in Upper Marlboro, MD. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our in-home care services brighten the lives of seniors who can benefit from a helping hand and a friendly smile. Our caregivers, who are seniors themselves, make your life easier by providing compassionate care in the...
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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...
Community Support Health Services, LLC, we put our clients first in providing home health care services in Maryland. Our extensive array of services guarantees your loved ones’ optimum health while remaining in the...
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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.