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.This packet includes all the forms required for a new patient consultation.
New Patient PacketRequired for telemedicine appointments.
Telemedicine Request FormFill 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 Form727-823-3220
131 2nd Ave. S.
St. Petersburg, FL 33701