MomsBloom Referral Information

MomsBloom services are intended for families in Kent & Ottawa counties with newborns and referrals must be submitted during pregnancy or before the child is 12 weeks old (adjusted for prematurity).

Eligibility requirements:

• Live in Kent or Ottawa county

• Currently pregnant or have a baby under 12 weeks old

• All income levels accepted (NO income/medicaid requirements)

• Have no or minimal local, trusted support

The best way to help a family sign up for MomsBloom is to send them the online enrollment form to complete at momsbloom.org/support OR you can help them complete the form over the phone or in person at your visit.

Our enrollment form takes about 10-15 minutes to complete. It will ask for family demographic information and requires a parent/legal guardian to sign a consent form. Please make sure the client is aware that you are completing this form AND they have given you consent to submit it on their behalf.