Seacrest Studios Visitor Request Form | Nicklaus Children's Hospital

Primary Contact Title or Role within Organization (if applicable):

Website and social media profiles:

Phone Number*:

( ) -

Have you hosted a Special Event at Nicklaus Children's before?*:

Yes
No

Learn more about Special Events

Visit Scheduling

Visits are scheduled Monday through Friday. Weekend dates are currently unavailable.

Please provide at least 2 dates.

Preferred Visit Time*:

10:30 AM - 12:00 PM
1:30 PM - 3:00 PM
4:30 PM - 6:00 PM

Select all that apply.

What are the goals of your visit? How will your visit benefit patients and families?*:

Estimated Gift In-Kind Value?*:

Giveaways

Giveaway items must be appropriate for all ages. Items should be identical or equitably similar in size and value. Seacrest Studios' Visitors/Guests may not distribute toys or gifts without prior review and approval.

Describe proposed giveaway items, if any. Please provide as much detail as possible:

Patient Privacy & Media

HIPAA is a federal law that guarantees patient and family rights to confidentiality and privacy. Visitors/Guests may not inquire about a patient's condition or hospital stay.

Patient and family consent is required for all photography and videography. Hospital approved media captured will be shared with Visitors/Guests post event, via email. Guest photography and videography is NOT permitted.

Would you like to receive approved photos and videos captured by hospital staff?:

Yes
No

What is the intended use for the media captured during the visit?:

Please note: promotion, advertising, campaigning and fundraising for third party entities are not permitted.

Press Releases, TV and Media requests must be approved and coordinated by our Marketing department. Will your event require PR?*:

Yes
No

Infection Prevention & Control

All Seacrest Studios' Guests must be in excellent health on the day of the visit. We recommend up-to-date immunizations and vaccines.

Nicklaus Children's staff will provide hand sanitizer, nitrile gloves, and germicidal wipes. Any items or games that will be shared among participants must be sanitized between each use.

Visitor Total Headcount

Up to 3 guests are welcome to assist in a Seacrest Studios Visit. Exceptions may be made for visitors requiring additional assistance; approval is required. All Guests must be at least 15 years old, and should be mindful of their attire, ensuring it is appropriate for a pediatric setting.

All Guests must wear Guest Pass and be accompanied by hospital staff at all times.

Security Clearance Acknowledgement*:

By checking this checkbox, I acknowledge that all guests are required to obtain clearance from hospital security prior to the event by providing name and date of birth as it appears on government issued ID, such as driver's license.

Number of people in your group*:

Seacrest Studio Visitor roles and responsibilities*:

Is there anything else we should know about your visit or group?:

Request a visit to Seacrest Studios

Contact Information

Visit Scheduling

Giveaways

Patient Privacy & Media

Infection Prevention & Control

Visitor Total Headcount