X0306 4 2012-11-19 0 0000799231 ALMOST FAMILY INC AFAM 0001515378 Ralston Nancy 9510 ORMSBY STATION ROAD SUITE 300 LOUISVILLE KY 40223 0 1 0 0 Sr. VP Ops, Florida Common Stock 2012-11-19 4 S 0 8400 18.00 D 3800 D Common Stock 2012-11-19 4 S 0 100 18.36 D 3700 D Option (right to buy) 24.16 2022-02-26 Common Stock 3500 3500 D Option (right to buy) 24.94 2018-06-16 Common Stock 2500 2500 D Option (right to buy) 33.27 2019-02-08 Common Stock 1600 1600 D Option (right to buy) 40.13 2019-12-13 Common Stock 1100 1100 D Option (right to buy) 36.69 2021-03-10 Common Stock 1600 1600 D The option becomes exercisable in four equal annual installments beginning on the first anniversary of the date of grant, March 11, 2011. Granted pursuant to the 2007 Stock & Incentive Compensation Plan. The option becomes exercisable in four equal annual installments beginning on the first anniversary of the date of grant, June 17, 2008. The option becomes exercisable in four equal annual installments beginning on the first anniversary of the date of grant, February 9, 2009. The option becomes exercisable in four equal annual installments beginning on the first anniversary of the date of grant, December 14, 2009. The reporting person previously reported 6,876 shares of the 8,400 shares sold as indirectly owned by RSSY Home Healthcare Services, LLC, the transfer of which 6,876 shares was not previously reported in accordance with Rule 16a-13. The option becomes exercisable in four equal annual installments beginning on the first anniversary of the date of grant, February 27, 2012. /s/ Steve Guenthner as Attorney -in- Fact for Nancy Ralston 2012-11-21