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Forms & DownloadsOffice Visits & AppointmentsAfter-Hours
CarePolicies & ProceduresImmunization Policy

Office Forms & Downloads

New Patient Forms

Individual Forms

School Forms

Patient Education Handouts

  • Browse this library of expert advice from the American Academy of Pediatrics. This collection of over 800 handouts covers 200 topics ranging from Acne to Whooping Cough.
  • AAP Parent Education Library

Policy Documents

Office Visits & Appointments

Well Child Visits

Well-child exams are a vital part of a child’s health care. These visits give us the opportunity to examine the child for overall health, growth, and development. We also discuss nutrition, sleep habits, and age-appropriate topics such as potty-training, dental care, and safety issues. Regular wellness visits allow us to detect and address health problems before they become serious, or in some cases prevent them entirely!

Many of the well-child visits in the first year of life include immunizations. These help to protect the child from some harmful and potentially life-threatening diseases.

We encourage parents to keep a list of questions they may have and bring the list to the visit.

Well child visit schedule and handouts »

Same Day Sick Visits

We understand that children can become ill quickly and unexpectedly, which is why we reserve a portion of our daily schedule for sick children. Please call us to make a same-day appointment.

After-Hours Care

If your child’s illness or injury is life-threatening, call 911.

Otherwise, for urgent matters that cannot wait until business hours, call (248) 691-8675 to be connected to a pediatric-trained triage nurse. Please keep in mind we are open until 8 pm Monday through Friday and until 1pm on Saturday and Sunday.  Please call for an appointment.

Bloom Pediatrics does not endorse minute clinic visits for acute care or sports physicals.

Bloom Pediatrics does not endorse vaccination at national drug store chains and believes your child’s medical home is the best place for all preventative care!  Come see us!

Urgent Care

Troy Beaumont Pediatric After Hours Clinic
44201 Dequindre Road
Troy, MI 48085

Mon – Fri
6:00 am – 10:00 pm

Sat–Sun
11:00 am–9:00 pm

Thanksgiving Day, Christmas Day and New Year’s Day
11:00 am – 9:00 pm

Emergency Care

William Beaumont Hospital – Royal Oak Emergency Room
3601 W. 13 Mile Road
Royal Oak, MI 48073

William Beaumont Hospital – Troy Emergency Room
44201 Dequindre Road
Troy, MI 48085

Children’s Hospital of Michigan – Troy Emergency Room
350 W. Big Beaver Road
Troy, MI 48084

Children’s Hospital of Michigan – Detroit Emergency Room
3901 Beaubien
Detroit, MI 48201

Office Policies & Procedures

Patient Privacy

Bloom Pediatrics providers and staff are governed by and comply with the federal Health Insurance Portability and Accountability Act (HIPAA). We must abide by the terms of our office Notice of Privacy Practices. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain. A copy of our current HIPAA statement is available upon request. Patients aged 18 and older must sign a waiver authorizing parental access to their account. Parents of patients over 18 will not be permitted to access any medical or billing information without written consent from the patient.

Missed Appointments and Late Arrivals

Missed appointments represent a cost to us, you, and to other patients that could have been seen during the time set aside for your child. Cancellations are required 24 hours prior to any well visit appointment and two hours prior to any sick visit appointment via phone call to the practice. A “No Show” fee of $50 will be applied if an appointment is missed and not cancelled within the stated timeframe.

If you are 10 (or more) minutes late for appointment, it will need to be rescheduled.

Records Requests

If you wish to obtain a copy of your medical records you must complete the authorization to release records form, which can be obtained by calling the office or at www.bloompediatricsmi.com.

The form needs to be completed in its entirety to process the request. Records will be mailed to the assigned account holder or available for pick up at the office within 5 business days of the request. A signed records release and payment of $20 must be received for a copy of the patient’s full medical record prior to completing the request. A summary of care can be provided at no cost. All outstanding balances must be paid before records are transferred.

Health Appraisal/Sports Physical Forms

A health appraisal or sports form will be generated during every well visit. Upon completion, the form will be added to the patient portal and made available in the portal documents for your convenience. If you require a health appraisal or sports form outside of a well visit and have had a well visit with a Bloom Pediatrics provider within the last year, you may request one by filling out the appropriate form’s first page. This portion is required to be completed by a parent or guardian (or patient over 18) before a doctor will sign and return it to the patient portal. Forms requested outside of a well visit require three business days for completion.

Referrals

Some insurances may require a referral by our office to see a specialist. Please refer to the list of recommended specialists given to you during your visit. If you did not receive a list, one can be requested by calling the office. Once you have scheduled the specialist appointment, please call Bloom Pediatrics with the date, time, and name of the specialist with whom you have an upcoming appointment, and your referral will be completed within 5 business days.

Medication Refills and Prior Authorizations

If you are in need of a medication refill or require a prior authorization for a medication, please call the office and leave a message for a nurse. Medication refills may require an associated medication refill or medication re-check visit. Prescriptions will be sent to the preferred pharmacy on file with the office unless otherwise requested by the assigned account holder.

Vaccines save lives.

At Bloom Pediatrics, we believe that all children should receive the recommended vaccines according to the guidelines provided by the American Academy of Pediatrics (AAP) and the CDC. Vaccines are safe and effective in preventing diseases and health complications in children and young adults. Regular vaccinations help children ward off infections, and are administered as one of the safest and best methods of disease prevention.

We are a vaccinating practice

Bloom Pediatrics requires that all of our patients are immunized according to the current vaccine schedule recommended by the American Academy of Pediatrics. All potential new patients must be up-to-date with their vaccines. We do not accept new families that do not vaccinate their children.

Immunization Resources