Dear Patient,

We would appreciate if you could fill out the below mentioned forms before your visit to Dr. Shah and bring them with you to your appointment. Please do not leave anything blank. If it does not apply to you, write “None” or “N/A”. Filling out forms in advance will help us to serve you in timely fashion. It will give you time to think about your medical history and ask other family members about pertinent family medical history.

Click on the appropriate form based on your symptoms that lead to your appointment with Dr. Shah

• Seizure
• Stroke
• Memory Problems
• Dizziness
• Headache
• Passing Out Spell (syncope)
• Pain
  

 Attachment