Patient Center

Patient Center

At Dr. Bloom's office we believe in making your experience at our office remarkable. Please share your comments with us so we can continue to improve!

Patient Satisfaction Survey - Submit Online


Online Forms

Download the necessary form(s), print it out and fill in the required information. Please fax us (Hastings: 269-945-3937, Wayland: 269-792-0520) your printed and completed form(s) or bring it with you to your appointment.

New Patient Information Form (Required) - Download & Print


What to Expect Upon Your Visit

Upon your arrival, our receptionist will welcome you as a member of our practice. If you haven't already done so online, we will ask you to complete a few forms. This paperwork provides us with your health history and other information related to providing you with the best vision solutions.


Payment Options

Dr. Bloom offers products and pricing to accommodate all budgets for your eye care and eyewear needs, including eyeglasses, contact lenses, routine office visits and medical office visits.

Our Office Accepts

  • Cash
  • Personal Checks
  • ATM
  • Visa, MasterCard, and Discover
  • Flexible Spending Plans
  • Health Savings Accounts (HSA)
  • Medical Savings Accounts (MSA)

Participating Insurances
We participate and accept most insurances including but not limited to, VSP, Eye Med, Medicare, Medicade