Forms

All new Shah and Associates Family Practice patients must fill out the Patient Information Form, HIPAA Consent Form, Patient Demographics Form, Financial Agreement Form, Permission to Discuss Patient Healthy Info Forms and the appropriate Medical History Form when coming in for the first visit.

To save time when you arrive at our office, please fill these out and bring them to your appointment. You can fill them out using Adobe Reader or you can print them and write in your information.

If you are a new patient, please fill out the following forms:

Medical History Forms

Please choose the age-appropriate Medical History Form from the following forms.
New patients from newborn to age 12, please fill out this form:

New patients aged 13-20, please fill out this form:

New patients over age 21, please fill out this form:

Thank you! We look forward to meeting you.

Resources for Helpful Forms

Power of Attorney

Power of Consent

Living Will

Immunizations

Shah and Associates Family Practice forms

For more information regarding your visit, please review our
Policies and FAQ.