Reminder: Health Risk Assessment Forms Due by Tuesday, September 15

Please make sure your form is sent using the correct fax number: 1-248-487-9514
Or email your form to: sdare@bloomfield.org

We request that you scan your document rather than taking a picture and sending it from your phone, as many forms come in blurry and difficult to read. Please be sure to include your name and your spouse's name on the form where indicated.  Forms submitted after the due date will not be accepted.

Avoid the last minute rush—submit your forms early!

Health Risk Assessment Form