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:
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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Amada Senior Care of Marietta provides thoughtful in home care that helps seniors remain comfortable and independent where they feel most at ease. Caregivers offer support with daily activities companionship memory care...
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...
Here at Senior Helpers – Virginia Beach, we are a Veteran owned and operated home health care franchise located in Virginia Beach. We provide high quality personal and companion care to individuals in the comfort of their...
Better Days Home Health, established in Hampton Roads, is dedicated to delivering personalized, compassionate care. Inspired by a neighbor's experience, we've made it our mission to ensure comfort and dignity in your own...
Our Norfolk location delivers reliable home care services to help your loved ones stay at home. We help seniors maintain their independence by supporting them where they need it. Whether you need dementia, Parkinson's,...
When you rely on Visiting Angels to provide home care services for your family, you expect your loved one’s needs will be met. The expertise of our elder care providers makes it possible for us to provide a wide range of...
Hope IN-Home Care Inc is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Best & Dependable Hhc is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Clean Hands Pure Hearts, we honor the legacy of our senior citizens by offering tailored services that cater to their unique needs. As a family-owned business, we understand the importance of reciprocating their care.
At Care with Empathy LLC, we're more than just a home care company- we're your trusted partner in providing compassionate, personalized care. With a dedicated team of experienced caregivers. We understand that each...
Atlantic provides a wide range of homecare services including non-medical companion and personal care, as well as, both pediatric and adult private duty nursing. Our professionals partner with our clients and their...
Beyond Believers LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Bedrock at Home - Virginia Beach is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
A Loving Touch Home Care, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Caring for Your Homecare Services, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Heartland Home Health&hospice is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Helpers Home Care of Virginia Beach, VA is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Home Helpers is a trusted provider of compassionate in home care in over 600 communities across America. We give peace of mind to the families we help by tailoring our in home care services to each situation, and offering...
our mission is simple yet profound: to provide dependable support and caring service in a family atmosphere. We believe that every individual deserves to age with dignity and independence within the familiar embrace of home.
CM Health Solutions is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Arcadia Health care provides Private Duty Health Care Workers in Virginia Beach, Norfolk, and Chesapeake areas. Arcadia is licensed, bonded, insured, and all workers have at least one year of experience. Complete...
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Changing Tides Home Care is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
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Faith Journey Home Care LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Our Mission Adom Care At Home is committed to providing quality care to the elderly and the sick while they age comfortably in their homes and or recover from Illness and injury.
Our vision is to become the leading provider of home care services in Virginia, recognized for our commitment to excellence, compassion, and innovation in care. We aim to empower individuals to age in place with dignity...
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Always Rise Personal Care llc is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Gentiva Hlth Serv VA Beach is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Hope, Care & Love Home Healthcare Services, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance...
A Taste Of The Kingdom LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
Interim Healthcare is a leader in the home care industry with 50 years of experience. We provide supportive services to frail and disabled individuals allowing them to remain independent in their homes. Our care...
C & R Divine Hands of Care, LLC is a home health care agency based in Virginia Beach, Virginia. Founded in 2015, the company specializes in providing medical and home health solutions, including medical case management...
Our mission Our mission is to provide exceptional home care services that empower individuals to live independently while receiving the support necessary to uphold their dignity and quality of life. We are dedicated to...
Cozy Home Care of Virginia is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At Ease Home Care is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
With Care Advantage in-home care locations across Virginia, we are poised to deliver the best possible services to all manner of clients in their home. We vow to make a positive contribution in the communities we serve...
Honesty Home Health, LLC is a home care provider that services in Virginia Beach, VA. Home care services allow seniors to remain safely in their own home while receiving medical care or assistance with...
At FirstLight, we understand your loved one deserves more than having someone who simply keeps them company. They deserve a caregiver who is passionate about helping them have their best day, every day. That’s why we do...
Through our unique system of in-home care that we call Interactive Caregiving™, our Comfort Keepers® engage clients in their care to enhance their independence and well-being. Interactive Caregiving™ includes four...
Changing Tides Home Care supports your loved one’s independence and well-being. We work closely with you to develop an individualized care plan, and to match you with caregivers who are well suited to your loved one’s...
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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.