Clinical Progress Note - PHONE APPOINTMENTS ONLY

If you have a phone appointment with Dr. Piper, Dr. Shah or Jeff Thompson PA, please click on this link to download this form. The Clinical Progress Note will ask for updates on any new doctors, allergies, medications, and health conditions.

Clinical Progress Note Form Requires Adobe Reader for digital signatures. Adobe Reader is not required if printing out the form.

Download Adobe Reader

New Patient Consult Packet

This packet includes all the forms required for a new patient consultation.

New Patient Packet

Telemedicine Consent Form

Required for telemedicine appointments.

Telemedicine Request Form

Report Request Form

Fill out the Report Request Form if you need a copy of Dr. Piper's or Dr. Shah's report for your records, physician, or insurance company.

Report Request Form

Quick Links


131 2nd Ave. S.

St. Petersburg, FL 33701