{"id":2404,"date":"2021-07-01T10:38:30","date_gmt":"2021-07-01T10:38:30","guid":{"rendered":"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/?page_id=2404"},"modified":"2026-02-26T13:47:01","modified_gmt":"2026-02-26T13:47:01","slug":"forms","status":"publish","type":"page","link":"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/forms\/","title":{"rendered":"Forms"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-parallax-none nonhundred-percent-fullwidth non-hundred-percent-height-scrolling PC2-title-sep-section\" style=\"--awb-background-position:center bottom;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:11%;--awb-padding-bottom:7%;--awb-background-color:#eeeeee;--awb-background-image:linear-gradient(180deg, rgba(0,0,0,0.2) 0%,rgba(0,0,0,0.2) 100%),url(https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2022\/03\/patient-resources-heading.jpg);;--awb-background-size:cover;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_6 1_6 fusion-one-sixth fusion-column-first fusion-no-small-visibility\" style=\"--awb-bg-size:cover;--awb-margin-top:0px;--awb-margin-bottom:0px;width:16.6666666667%;width:calc(16.6666666667% - ( ( 0 + 0 ) * 0.166666666667 ) );margin-right: 0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_2_3 2_3 fusion-two-third fusion-animated hero-header\" style=\"--awb-bg-size:cover;--awb-margin-top:45px;--awb-margin-bottom:45px;width:66.6666666667%;width:calc(66.6666666667% - ( ( 0 + 0 ) * 0.666666666667 ) );margin-right: 0px;\" data-animationType=\"zoomIn\" data-animationDuration=\"0.9\" data-animationOffset=\"top-into-view\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-1\"><h1 style=\"text-align: center\">FORMS<\/h1>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_6 1_6 fusion-one-sixth fusion-column-last fusion-no-small-visibility\" style=\"--awb-bg-size:cover;--awb-margin-top:0px;--awb-margin-bottom:0px;width:16.6666666667%;width:calc(16.6666666667% - ( ( 0 + 0 ) * 0.166666666667 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-equal-height-columns PC2-about-sec2\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:2%;--awb-padding-bottom:2%;--awb-background-color:#ffffff;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-first fusion-column-inner-bg-wrapper fusion-column-liftup-border\" style=\"--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-inner-bg-size:cover;--awb-inner-bg-box-shadow:1px 1px 2px 1px #a3a3a3;;width:33.3333333333%;width:calc(33.3333333333% - ( ( 4% + 4% ) * 0.333333333333 ) );margin-right: 4%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-liftup\"><a class=\"fusion-column-anchor\" href=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2026\/02\/NEW-NP-Paperwork.pdf\" rel=\"noopener noreferrer\" target=\"_blank\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-max-width:170px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"291\" height=\"276\" title=\"patient-forms-icon-1-e1522843815820\" src=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/patient-forms-icon-1-e1522843815820.png\" alt class=\"img-responsive wp-image-2405\" srcset=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/patient-forms-icon-1-e1522843815820-200x190.png 200w, https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/patient-forms-icon-1-e1522843815820.png 291w\" sizes=\"(max-width: 1000px) 100vw, 291px\" \/><\/span><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-2\"><p style=\"text-align: center\"><strong>NEW PATIENT FORMS ELECTRONIC<\/strong><br \/>\nDownloadable PDF<\/p>\n<\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-inner-bg-wrapper fusion-column-liftup-border\" style=\"--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-inner-bg-size:cover;--awb-inner-bg-box-shadow:1px 1px 2px 1px #a3a3a3;;width:33.3333333333%;width:calc(33.3333333333% - ( ( 4% + 4% ) * 0.333333333333 ) );margin-right: 4%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-liftup\"><a class=\"fusion-column-anchor\" href=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2026\/02\/NEW-NP-Paperwork-SPANISH.pdf\" rel=\"noopener noreferrer\" target=\"_blank\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-max-width:160px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-2 hover-type-none\"><img decoding=\"async\" width=\"253\" height=\"249\" title=\"lounge-icon-patient-registration-e1522843627127\" src=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/lounge-icon-patient-registration-e1522843627127.png\" alt class=\"img-responsive wp-image-2407\" srcset=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/lounge-icon-patient-registration-e1522843627127-200x197.png 200w, https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/lounge-icon-patient-registration-e1522843627127.png 253w\" sizes=\"(max-width: 1000px) 100vw, 253px\" \/><\/span><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-3\"><p style=\"text-align: center\"><strong>NUEVOS FORMULARIOS DE<br \/>\nPACIENTES (ESPA\u00d1OL)<\/strong><br \/>\nDescargar PDF<\/p>\n<\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-last fusion-column-inner-bg-wrapper fusion-column-liftup-border\" style=\"--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-inner-bg-size:cover;--awb-inner-bg-box-shadow:1px 1px 2px 1px #a3a3a3;;width:33.3333333333%;width:calc(33.3333333333% - ( ( 4% + 4% ) * 0.333333333333 ) );\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-liftup\"><a class=\"fusion-column-anchor\" href=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2026\/02\/INTAKE_NEW-updated-1.5.26.pdf\" rel=\"noopener noreferrer\" target=\"_blank\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-max-width:200px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-3 hover-type-none\"><img decoding=\"async\" width=\"257\" height=\"191\" title=\"New-Patient-Icon\" src=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/New-Patient-Icon.png\" alt class=\"img-responsive wp-image-2409\" srcset=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/New-Patient-Icon-200x149.png 200w, https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/New-Patient-Icon.png 257w\" sizes=\"(max-width: 1000px) 100vw, 257px\" \/><\/span><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-4\"><p style=\"text-align: center\"><strong>APPOINTMENT REQUEST FORM<\/strong><br \/>\nDownloadable PDF<\/p>\n<\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-first fusion-column-inner-bg-wrapper fusion-column-liftup-border\" style=\"--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-inner-bg-size:cover;--awb-inner-bg-box-shadow:1px 1px 2px 1px #a3a3a3;;width:33.3333333333%;width:calc(33.3333333333% - ( ( 4% ) * 0.333333333333 ) );margin-right: 4%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><span class=\"fusion-column-inner-bg hover-type-liftup\"><a class=\"fusion-column-anchor\" href=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2026\/02\/Medical-Records-Release-Form-NEW.pdf\" rel=\"noopener noreferrer\" target=\"_blank\"><span class=\"fusion-column-inner-bg-image\"><\/span><\/a><\/span><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-column-content-centered\"><div class=\"fusion-column-content\"><div class=\"fusion-image-element fusion-image-align-center in-legacy-container\" style=\"text-align:center;--awb-max-width:170px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><div class=\"imageframe-align-center\"><span class=\" fusion-imageframe imageframe-none imageframe-4 hover-type-none\"><img decoding=\"async\" width=\"192\" height=\"192\" title=\"icon4\" src=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/icon4.png\" alt class=\"img-responsive wp-image-2411\" srcset=\"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/icon4-66x66.png 66w, https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/icon4-150x150.png 150w, https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-content\/uploads\/sites\/254\/2021\/07\/icon4.png 192w\" sizes=\"(max-width: 192px) 100vw, 192px\" \/><\/span><\/div><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"margin-left: auto;margin-right: auto;margin-top:30px;width:100%;\"><\/div><div class=\"fusion-sep-clear\"><\/div><div class=\"fusion-text fusion-text-5\"><p style=\"text-align: center\"><strong>MEDICAL INFORMATION RELEASE<\/strong><br \/>\nDownloadable PDF<\/p>\n<\/div><\/div><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_3 1_3 fusion-one-third fusion-column-last\" style=\"--awb-bg-size:cover;width:33.3333333333%;width:calc(33.3333333333% - ( ( 4% ) * 0.333333333333 ) );\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":13,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-2404","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-json\/wp\/v2\/pages\/2404","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-json\/wp\/v2\/comments?post=2404"}],"version-history":[{"count":0,"href":"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-json\/wp\/v2\/pages\/2404\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.toplinemd.com\/floridaperinatalcenter\/wp-json\/wp\/v2\/media?parent=2404"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}