New Patients

The Pediatric Place is accepting new patients!

The Pediatric Place was established by Dr. Bergman to provide optimal personalized care for your child in a comfortable office environment. We take pride in knowing your child well and achieving a personal level of attention with your child, the parents, and grandparents. Our goal is to merge the old-fashioned days of very personal doctor-patient relationships with some of the benefits of our modern medical system: computerized medical records, child development and adolescent screening tools, novel educational and intervention programs, access to web-based unbiased information, and constant continuing pediatric education to provide your child the best care possible.

Please review Dr. Bergman’s and Dr. Hlobik’s bio pages and ask for referrals from community friends who bring their children to our office to determine if this is the right fit you are seeking for your child’s pediatric care.

You may call the office to arrange an appointment to meet you and your child (no fee). If you are expecting a baby, a Prenatal Visit is an ideal opportunity for you to schedule time to meet with our doctors to review a variety of questions or concerns as you transition to becoming parents and receiving guidance from your pediatrician. From the Forms page, complete either the Meet and Greet or Prenatal form.


Dr. Bergman or Dr. Hlobik will visit you and your newborn in the hospital (Northside or Emory JC).  Depending on your proximity to the office, Dr. Bergman may be able to visit your home for your newborn’s first exam. This exam is usually scheduled 2-4 days after leaving the hospital. Your insurance may apply this visit to your deductible if they do not cover it.

Before your first newborn visit to the office, please:

Review our Office and Insurance Policy

Complete the following forms:

Practice Agreement – HIPAA and Billing Policies(read only-you do not need to bring in)
Patient Contact and Consent Form (Online form: complete one per family)
Newborn Medical History
Newborn Insurance Form
Also, please bring:
Hospital discharge forms
Insurance card – be sure to add your newborn to your policy

Transferring to The Pediatric Place

Medical Records  If you are transferring from another practice, please make sure we have your child(s) medical records before your first visit. If you are transferring from out-of-state and scheduling a well-visit, we will need vaccine records before this visit. Most practices will fax a copy to us and mail the remaining records.

To obtain records from your previous medical practice, you can use our Request for Medical Records to complete and send to them. Or, you can contact your previous medical practice and request a copy of their medical release form; provide the practice with our office info – 9570 Nesbit Ferry Rd. Suite 201, Alpharetta, GA 30022, 770-640-8119 – to have your child’s medical records sent to us.

Confirm Insurance  Call your insurance company to verify we are in-network and that Dr. Bergman is the PCP (primary care physician). Here are insurance companies we have contracts with. We do accept insurances we are not contracted with; however, you may have out-of-pocket expenses for most visits. You can call our office if you have general questions about your insurance.

Complete New Patient Forms  Please complete the following forms. Be sure to email, fax, mail or deliver them to the office before your first appointment. After we create your patient records, we will call you to set your appointment:
Practice Agreement – HIPAA and Billing Policies (read only-you do not need to bring in)
Patient Contact and Consent Form (Online form: complete one per family)
Patient Contact and Consent Form for 18 year old (Online form: for a patient 18 years or older to complete)
Insurance and Finance Policy (one per family, initial, sign)
Medical History (complete for each child)
Request Medical Records (to request medical records from your previous pediatrician – request in advance of 1st visit)

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