{"id":1876,"date":"2026-01-16T17:12:13","date_gmt":"2026-01-16T22:12:13","guid":{"rendered":"https:\/\/toplinemultist.wpengine.com\/shores-pediatrics\/?page_id=1876"},"modified":"2026-05-14T02:46:01","modified_gmt":"2026-05-14T02:46:01","slug":"forms-policies","status":"publish","type":"page","link":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/","title":{"rendered":"Forms &amp; Policies"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background fusion-parallax-none hundred-percent-fullwidth non-hundred-percent-height-scrolling lazyload header-img\" style=\"--awb-background-position:center top;--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-bottom:0px;--awb-margin-bottom:0px;--awb-background-size:cover;--awb-flex-wrap:wrap;\" data-bg=\"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-content\/uploads\/sites\/310\/2025\/11\/Mask-group-19.png\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-center fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-left:3rem;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:150px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:150px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:0px;--awb-margin-right-small:0px;--awb-margin-bottom-small:20px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:48;line-height:1.21;\"><h1 style=\"color: #fff; font-size: 48px; font-weight: 400;\">Forms &amp; Policies<\/h1><\/h1><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column custom-shape\" style=\"--awb-padding-bottom:0px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-section-separator section-separator big-half-circle fusion-section-separator-1\" style=\"--awb-spacer-height:99px;--awb-svg-margin-left:1.92%;--awb-svg-margin-right:1.92%;--awb-svg-margin-left-medium:1.92%;--awb-svg-margin-right-medium:1.92%;--awb-svg-margin-left-small:1.92%;--awb-svg-margin-right-small:1.92%;--awb-divider-height:99px;--awb-spacer-padding-top:inherit;--awb-sep-padding:0;--awb-svg-padding:0;\"><div class=\"fusion-section-separator-svg\"><svg class=\"fusion-big-half-circle-candy\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.1\" width=\"100%\" height=\"100\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" fill=\"rgba(255,255,255,1)\"><path d=\"M0 100 C40 0 60 0 100 100 Z\"><\/path><\/svg><\/div><div class=\"fusion-section-separator-spacer\"><div class=\"fusion-section-separator-spacer-height\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" 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-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1289.6px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.6666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.6666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.88%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\" style=\"--awb-content-alignment:center;\"><p class=\"p1\"><b>Forms<\/b><\/p>\n<p class=\"p2\"><b>Medical Records Release Request<\/b><b><\/b><\/p>\n<p class=\"p2\">To request that your child\u2019s medical records from a previous physician or specialist be released to Shores Pediatrics, please <a href=\"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-content\/uploads\/sites\/310\/2026\/01\/Shores-Pediatrics-Record-Release-Request.pdf\"><b>click here<\/b><\/a> to download our Medical Records Release form. Once completed, fax the form to the appropriate provider.<\/p>\n<p class=\"p2\">Please also send a copy to our office via fax at <b>305-757-8011<\/b> or email at <a href=\"mailto:shorespediatrics@femwell.com\"><span class=\"s1\"><b>shorespediatricsinfo@femwell.com<\/b><\/span><\/a>.<\/p>\n<p class=\"p2\">If you are requesting a copy of your child\u2019s medical records from <b>our<\/b> office, please email your request to <a href=\"mailto:shorespediatrics@femwell.com\"><span class=\"s1\"><b>shorespediatricsinfo@femwell.com<\/b><\/span><\/a>.<br \/>\nInclude: your child\u2019s full name, date of birth, the specific records needed, and who they are for (e.g., insurance, specialist, personal).<\/p>\n<p class=\"p2\">Copies will be available for pick-up within <b>3 business days<\/b>. If you need them sooner, please contact the office directly. A processing fee applies and is due at pick-up.<\/p>\n<p class=\"p2\"><b>Expecting Forms<\/b><\/p>\n<p class=\"p2\">Please <a href=\"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-content\/uploads\/sites\/310\/2026\/01\/NEW-Shores-Pediatrics-Prenatal-Forms.pdf\"><b>click here<\/b><\/a> to download the forms for expecting parents. Once completed, email them to <a href=\"mailto:shorespediatrics@femwell.com\"><span class=\"s1\"><b>shorespediatricsinfo@femwell.com<\/b><\/span><\/a>.<\/p>\n<p>For additional details, visit the <a href=\"\/shores-pediatrics\/new-patients\/\"><b>New Patient<\/b><\/a> section of our website.<\/p>\n<p class=\"p2\"><b>Transferring Patient Forms<\/b><\/p>\n<p class=\"p2\">Please <a href=\"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-content\/uploads\/sites\/310\/2026\/01\/NEW-Shores-Pediatrics-Transferring-Patient-Form.pdf\"><b>click here<\/b><\/a><span class=\"s2\">\u00a0<\/span>to download the forms for patients transferring from another practice. Once completed, email them to <b>shorespediatricsinfo@femwell.com<\/b>.<\/p>\n<p>For more information, see the <a href=\"\/shores-pediatrics\/new-patients\/\"><b>New Patient<\/b><\/a> section of our website.<\/p>\n<p class=\"p2\"><b>ADHD Assessment (Vanderbilt Assessment Scale)<\/b><\/p>\n<p class=\"p2\">If your physician has requested the Vanderbilt Assessment Scale to evaluate your child for possible ADHD, please <a href=\"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-content\/uploads\/sites\/310\/2026\/01\/Shores-Pediatrics-NICHQVanderbiltAssessment-1.pdf\"><b>click here<\/b><\/a> to download the necessary forms. Once completed, please return the forms to our office at your earliest convenience. You will also need to schedule a follow-up appointment with your physician to review and discuss the assessment results.<br \/>\n<span class=\"s3\"><br \/>\n<\/span><span class=\"s4\"><b>Policies<\/b><\/span><\/p>\n<p class=\"p5\"><b>Immunization Policy<\/b><\/p>\n<p class=\"p5\">Our physicians strongly believe in and follow the vaccination guidelines recommended by the <b>American Academy of Pediatrics (AAP)<\/b> and the <b>Centers for Disease Control and Prevention (CDC)<\/b>. For families choosing not to vaccinate, we recommend seeking a practice aligned with that philosophy.<\/p>\n<p class=\"p5\">To view the AAP\u2019s recommended immunization schedule, <a href=\"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-content\/uploads\/sites\/310\/2026\/01\/Shores-Pediatrics-0-18yrs-child-combined-schedule.pdf\"><b>click here<\/b><\/a>.<\/p>\n<p class=\"p5\"><b>Payment Policy<\/b><\/p>\n<p class=\"p5\">All co-pays, charges, and outstanding balances are due at the time of your child\u2019s appointment. We accept all major credit cards, personal checks, and cash.<\/p>\n<p class=\"p5\">If you have questions regarding billing, previous statements, or insurance, please contact our office at <a href=\"tel:+13057578040\"><span class=\"s5\"><b>305-757-8040<\/b><\/span><\/a>.<\/p>\n<p class=\"p5\"><b>Walk-In Policy<\/b><\/p>\n<p class=\"p5\">All appointments must be scheduled in advance. <b>Walk-in visits are not accepted.<\/b><br \/>\nWe will make every effort to accommodate your child as soon as possible. Thank you for your understanding and cooperation.<\/p>\n<p class=\"p5\"><b>Privacy Practices<\/b><\/p>\n<p class=\"p5\">To view our Privacy Practices, <a href=\"https:\/\/www.toplinemd.com\/practice-terms-policies\/#npp-en\" target=\"_blank\" rel=\"noopener\"><b>click here<\/b><\/a>.<\/p>\n<p class=\"p5\"><b>Terms and Policies<\/b><\/p>\n<p class=\"p5\">To view our Terms and Policies, <a href=\"https:\/\/www.toplinemd.com\/practice-terms-policies\/\" target=\"_blank\" rel=\"noopener\"><b>click here<\/b><\/a>.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.6666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container has-pattern-background has-mask-background hundred-percent-fullwidth non-hundred-percent-height-scrolling home-sec6\" 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:80px;--awb-padding-bottom:83px;--awb-background-color:#4fb2cf;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-center fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-blend:overlay;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-2\" style=\"--awb-font-size:30px;\"><h2 class=\"wh3-h2-60\" style=\"text-align: center;\">BOOK AN APPOINTMENT TODAY!<\/h2>\n<\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-1 fusion-button-default-span fusion-button-default-type button-font\" style=\"--button-border-radius-top-left:14px;--button-border-radius-top-right:14px;--button-border-radius-bottom-right:14px;--button-border-radius-bottom-left:14px;--button_text_transform:uppercase;--button_typography-font-family:&quot;Libre Franklin&quot;;--button_typography-font-style:normal;--button_typography-font-weight:700;\" target=\"_self\" href=\"\/shores-pediatrics\/contact\/\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Request an appointment<\/span><\/a><\/div><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"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-1876","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.0.1 - aioseo.com -->\n\t<meta name=\"description\" content=\"Forms &amp; PoliciesForms Medical Records Release Request To request that your child\u2019s medical records from a previous physician or specialist be released to Shores Pediatrics, please click here to download our Medical Records Release form. Once completed, fax the form to the appropriate provider. Please also send a copy to our office via fax at\" \/>\n\t<meta name=\"robots\" content=\"max-image-preview:large\" \/>\n\t<link rel=\"canonical\" href=\"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/\" \/>\n\t<meta name=\"generator\" content=\"All in One SEO (AIOSEO) 5.0.0.1\" \/>\n\t\t<meta property=\"og:locale\" content=\"en_US\" \/>\n\t\t<meta property=\"og:site_name\" content=\"Shores Pediatrics -\" \/>\n\t\t<meta property=\"og:type\" content=\"article\" \/>\n\t\t<meta property=\"og:title\" content=\"Forms &amp; Policies - Shores Pediatrics\" \/>\n\t\t<meta property=\"og:description\" content=\"Forms &amp; PoliciesForms Medical Records Release Request To request that your child\u2019s medical records from a previous physician or specialist be released to Shores Pediatrics, please click here to download our Medical Records Release form. Once completed, fax the form to the appropriate provider. Please also send a copy to our office via fax at\" \/>\n\t\t<meta property=\"og:url\" content=\"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/\" \/>\n\t\t<meta property=\"article:published_time\" content=\"2026-01-16T22:12:13+00:00\" \/>\n\t\t<meta property=\"article:modified_time\" content=\"2026-05-14T02:46:01+00:00\" \/>\n\t\t<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n\t\t<meta name=\"twitter:title\" content=\"Forms &amp; Policies - Shores Pediatrics\" \/>\n\t\t<meta name=\"twitter:description\" content=\"Forms &amp; PoliciesForms Medical Records Release Request To request that your child\u2019s medical records from a previous physician or specialist be released to Shores Pediatrics, please click here to download our Medical Records Release form. Once completed, fax the form to the appropriate provider. Please also send a copy to our office via fax at\" \/>\n\t\t<script type=\"application\/ld+json\" class=\"aioseo-schema\">\n\t\t\t{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/forms-policies\\\/#breadcrumblist\",\"itemListElement\":[{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics#listItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\",\"nextItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/forms-policies\\\/#listItem\",\"name\":\"Forms &amp; Policies\"}},{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/forms-policies\\\/#listItem\",\"position\":2,\"name\":\"Forms &amp; Policies\",\"previousItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics#listItem\",\"name\":\"Home\"}}]},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/#organization\",\"name\":\"Shores Pediatrics\",\"url\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/forms-policies\\\/#webpage\",\"url\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/forms-policies\\\/\",\"name\":\"Forms & Policies - Shores Pediatrics\",\"description\":\"Forms & PoliciesForms Medical Records Release Request To request that your child\\u2019s medical records from a previous physician or specialist be released to Shores Pediatrics, please click here to download our Medical Records Release form. Once completed, fax the form to the appropriate provider. Please also send a copy to our office via fax at\",\"inLanguage\":\"en-US\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/#website\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/forms-policies\\\/#breadcrumblist\"},\"datePublished\":\"2026-01-16T17:12:13-05:00\",\"dateModified\":\"2026-05-14T02:46:01-04:00\"},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/#website\",\"url\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/\",\"name\":\"Shores Pediatrics\",\"inLanguage\":\"en-US\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.toplinemd.com\\\/shores-pediatrics\\\/#organization\"}}]}\n\t\t<\/script>\n\t\t<!-- All in One SEO -->\n\n","aioseo_head_json":{"title":"Forms & Policies - Shores Pediatrics","description":"Forms & PoliciesForms Medical Records Release Request To request that your child\u2019s medical records from a previous physician or specialist be released to Shores Pediatrics, please click here to download our Medical Records Release form. Once completed, fax the form to the appropriate provider. Please also send a copy to our office via fax at","canonical_url":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/","robots":"max-image-preview:large","keywords":"","webmasterTools":{"miscellaneous":""},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"BreadcrumbList","@id":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/#breadcrumblist","itemListElement":[{"@type":"ListItem","@id":"https:\/\/www.toplinemd.com\/shores-pediatrics#listItem","position":1,"name":"Home","item":"https:\/\/www.toplinemd.com\/shores-pediatrics","nextItem":{"@type":"ListItem","@id":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/#listItem","name":"Forms &amp; Policies"}},{"@type":"ListItem","@id":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/#listItem","position":2,"name":"Forms &amp; Policies","previousItem":{"@type":"ListItem","@id":"https:\/\/www.toplinemd.com\/shores-pediatrics#listItem","name":"Home"}}]},{"@type":"Organization","@id":"https:\/\/www.toplinemd.com\/shores-pediatrics\/#organization","name":"Shores Pediatrics","url":"https:\/\/www.toplinemd.com\/shores-pediatrics\/"},{"@type":"WebPage","@id":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/#webpage","url":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/","name":"Forms & Policies - Shores Pediatrics","description":"Forms & PoliciesForms Medical Records Release Request To request that your child\u2019s medical records from a previous physician or specialist be released to Shores Pediatrics, please click here to download our Medical Records Release form. Once completed, fax the form to the appropriate provider. Please also send a copy to our office via fax at","inLanguage":"en-US","isPartOf":{"@id":"https:\/\/www.toplinemd.com\/shores-pediatrics\/#website"},"breadcrumb":{"@id":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/#breadcrumblist"},"datePublished":"2026-01-16T17:12:13-05:00","dateModified":"2026-05-14T02:46:01-04:00"},{"@type":"WebSite","@id":"https:\/\/www.toplinemd.com\/shores-pediatrics\/#website","url":"https:\/\/www.toplinemd.com\/shores-pediatrics\/","name":"Shores Pediatrics","inLanguage":"en-US","publisher":{"@id":"https:\/\/www.toplinemd.com\/shores-pediatrics\/#organization"}}]},"og:locale":"en_US","og:site_name":"Shores Pediatrics -","og:type":"article","og:title":"Forms &amp; Policies - Shores Pediatrics","og:description":"Forms &amp; PoliciesForms Medical Records Release Request To request that your child\u2019s medical records from a previous physician or specialist be released to Shores Pediatrics, please click here to download our Medical Records Release form. Once completed, fax the form to the appropriate provider. Please also send a copy to our office via fax at","og:url":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/","article:published_time":"2026-01-16T22:12:13+00:00","article:modified_time":"2026-05-14T02:46:01+00:00","twitter:card":"summary_large_image","twitter:title":"Forms &amp; Policies - Shores Pediatrics","twitter:description":"Forms &amp; PoliciesForms Medical Records Release Request To request that your child\u2019s medical records from a previous physician or specialist be released to Shores Pediatrics, please click here to download our Medical Records Release form. Once completed, fax the form to the appropriate provider. Please also send a copy to our office via fax at"},"aioseo_meta_data":{"post_id":"1876","title":null,"description":null,"keywords":[],"keyphrases":{"focus":{"keyphrase":"","score":0,"analysis":{"keyphraseInTitle":{"score":0,"maxScore":9,"error":1}}},"additional":[]},"primary_term":null,"canonical_url":null,"og_title":null,"og_description":null,"og_object_type":"default","og_image_type":"default","og_image_url":null,"og_image_width":null,"og_image_height":null,"og_image_custom_url":null,"og_image_custom_fields":null,"og_video":"","og_custom_url":null,"og_article_section":null,"og_article_tags":[],"twitter_use_og":false,"twitter_card":"default","twitter_image_type":"default","twitter_image_url":null,"twitter_image_custom_url":null,"twitter_image_custom_fields":null,"twitter_title":null,"twitter_description":null,"schema":{"blockGraphs":[],"customGraphs":[],"default":{"data":{"Article":[],"Course":[],"Dataset":[],"FAQPage":[],"Movie":[],"Person":[],"Product":[],"ProductReview":[],"Car":[],"Recipe":[],"Service":[],"SoftwareApplication":[],"WebPage":[]},"graphName":"WebPage","isEnabled":true},"graphs":[]},"schema_type":"default","schema_type_options":null,"pillar_content":false,"robots_default":true,"robots_noindex":false,"robots_noarchive":false,"robots_nosnippet":false,"robots_nofollow":false,"robots_noimageindex":false,"robots_noodp":false,"robots_notranslate":false,"robots_max_snippet":"-1","robots_max_videopreview":"-1","robots_max_imagepreview":"large","priority":null,"frequency":"default","local_seo":null,"limit_modified_date":false,"open_ai":"{\"title\":{\"suggestions\":[],\"usage\":0},\"description\":{\"suggestions\":[],\"usage\":0}}","created":"2026-02-06 21:05:51","updated":"2026-05-14 03:13:33","focus_keyword":null,"additional_keywords":null,"truseo_locale":null,"ai":null,"breadcrumb_settings":null,"seo_analyzer_scan_date":null},"aioseo_breadcrumb":"<div class=\"aioseo-breadcrumbs\"><span class=\"aioseo-breadcrumb\">\n\t\t\t<a href=\"https:\/\/www.toplinemd.com\/shores-pediatrics\" title=\"Home\">Home<\/a>\n\t\t<\/span><span class=\"aioseo-breadcrumb-separator\">&raquo;<\/span><span class=\"aioseo-breadcrumb\">\n\t\t\tForms &amp; Policies\n\t\t<\/span><\/div>","aioseo_breadcrumb_json":[{"label":"Home","link":"https:\/\/www.toplinemd.com\/shores-pediatrics"},{"label":"Forms &amp; Policies","link":"https:\/\/www.toplinemd.com\/shores-pediatrics\/forms-policies\/"}],"_links":{"self":[{"href":"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-json\/wp\/v2\/pages\/1876","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-json\/wp\/v2\/comments?post=1876"}],"version-history":[{"count":0,"href":"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-json\/wp\/v2\/pages\/1876\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.toplinemd.com\/shores-pediatrics\/wp-json\/wp\/v2\/media?parent=1876"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}