Receive care at home or during a curated luxury stay
Bloomhaven is the ultimate dual option concierge service. Select the environment that fits your life, and your clinical experience is tailored around it.
The At Home Concierge Suite
Restoration in Your Private Residence
White glove virtual consultations, personalized biomarker intake, and custom diagnostic test kits (PGx, RPP, specialized panels) delivered directly to your doorstep. Private, unhurried, and tailored to your home environment.
The Luxury Hotel Partner Experience
An Exclusive Restorative Sanctuary
Elevate your recovery with a tailored clinical wellness suite paired with a stay at one of our premier luxury hotel partners. Complete with 24/7 room service, serene environments, and dedicated virtual and concierge clinical support.
Find out how your specific plan unlocks our exclusive member benefits.
Universal Clinical Intake
Patient Intake Form
Complete every section to securely transmit your data to our clinical intake team.
Section 1: Patient Information
Insurance Card (photo or PDF)
Driver's License / State ID (photo)
Section 2: Comprehensive Clinical Symptom Checklist
COVID-19 & Upper Respiratory PCR
Pulmonary & Respiratory Health
Women's Health, Vaginal Wellness & Urinary Panel
Cardiovascular & Heart Health
Gastrointestinal & Systemic Wellness
Metabolic, Endocrine & Thyroid Function (Diabetes/MODY)
Immunodeficiency & Infectious Disease History
Neurological, Vision & Hereditary Eye Health
Emotional, Psychiatric & Mental Health
Section 3: Medication & Diagnostic History
Are you experiencing side effects from your current medications?
Are your current medications feeling ineffective or failing to control symptoms?
Do you have a personal or family history of genetic disorders?
Section 4: HIPAA Privacy Notice & Authorization for Care
Privacy Acknowledgment: I acknowledge that my health information will be kept strictly confidential under HIPAA regulations and used solely for treatment, payment, and healthcare operations.
Authorization: I authorize Bloomhaven Postpartum Recovery and Wellness Center and its affiliated clinical providers to evaluate this intake form, perform non-invasive diagnostic screenings as indicated, and consult with my listed healthcare providers.
Direct Patient Instructions
What To Do Next
Our telehealth platform uses a highly direct onboarding process. Follow these three immediate steps to launch your care.
Submit the Electronic Intake Form
Securely transmitted to our clinical intake team
Fill out every section of the digital intake form above completely and press the submit button. This immediately transmits your data securely to our primary intake clinical team.
Complete Your Virtual Consultation
Required before medical orders are approved
Check your email inbox for a secure booking link from our team. Click the link to pick a convenient date and time for your face to face video conference with your remote nurse practitioner.
Receive and Complete Your Swab or Blood Spot Kit
Zero needles required
Once approved during your consultation, your testing kit will be shipped to your home or delivered to your assisted living suite. Follow the collection steps, allow your blood spot card to dry for twenty four hours, and mail it to the lab using the prepaid envelope.
Secure Patient Enrollment Portal
Begin Your Personalized Care Journey
Select the service ecosystem below that matches your current health goals to register your patient account and request your diagnostic kit.
Complete Your Digital Registration
Select a service path above, then enter your information below to create your secure patient portal account.
Insurance Information and Coverage
Bloomhaven is fully integrated with major insurance networks. During the final step of registration you will be able to upload your insurance card to verify benefits automatically.