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New Patients

Please click on the link below to complete basic patient information.  Once submitted, a clinical representative will contact you shortly.  Please contact our office if you have any questions in the meantime.  Please complete the new patient forms below, and submit with your New Patient Profile.

All forms must be completed prior to your initial assessment.


New Patient Profile


Practice Policies & Rates

Pediatric Patient Profile

Cancellation/Attendance Policy

Privacy Practices Acknowledgement

audiovisual policy consent

Credit Card Authorization Form

Records release consent form

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Bloom Behavioral Solutions strives to be able to provide services to all patients.  However, we may not always be able to meet specific needs, or be equipped to perform therapeutic services for certain patient populations.  Such patient populations may include, but not limited to patients who are medically complex.  Please contact us for questions if your child has specific medical conditions that require additional equipment, or attention.  Thank you.

Bloom has been an answer to our prayers. Our lives have been greatly improving. I can't wait to see how much more my daughter improves over summer camp. The more "bloom" we get the better we feel.


Bloom is an amazing place for children! I love it!


These are by far the best therapists I have ever met. I am amazed at the doors they have opened for my son! Thank you, Bloom!


On our first visit here my daughter instantly clicked and bonded with the staff which is very rare for her to do so with strangers. It's just so warm and inviting here and we feel comfortable here. So glad that we chose to come to Bloom! Staff is attentive, thorough, caring, and overall wonderful.

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