Vascular Institute of Southern Nevada
Kenneth J. Shah, MD

New Patient to fill out this History intake form before 1st visit

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Credit Card Payment Form

Please schedule a Doctor visit (telehealth or in office) to review any health questions and items forwarded to our office. This includes EKG strips, Tracker data for BP and HR 

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1. Direct e=print at drkenshahekg@hpeprint.com

2. Fax to: 702-616-0505 

3. Email request with pdf attachment to hello@drkenshah.com

Use this Form to fill out to have records released to Dr KJ Shah

HIPPA PHI Privacy Notice

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New Patient Registration Form (for ALL NEW patients and also for Existing patients if any CHANGES to Insurance, Address, Email or Phone numbers)

Record Request from Dr Shah