www.signaturemeds.net
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Forms

Welcome to the medical practice of Mohamed Shahed, MD. We are elated that you will be joining us here at Signature Meds, LLC! Attached are printable forms that you can complete and bring with you to your office visit, along with your photo ID and insurance card.

•  Please print all five forms, as they are all part of the new patient processing.

•  And also, please be prepared to pay any copays at the time of your visit.

​For your convenience our office accepts the following forms of payments: check, cash, Visa, Mastercard, American Express and Care Credit. 
 
We look forward to providing you with an optimal health experience.

Click to download forms

New Patient Health Forms
HIPPA COMPLIANCE
PHQ
New Patient Agreement
Office Policy for Correspondence
Once downloaded, you can either print and fill out manually, or open in a PDF viewer or document
​application, and fill out digitally. Then save file and email to ​[email protected].
***    Click below for Care Credit information    ​***

www.carecredit.com/go/287PTM/

Site Links

Instagram: ​@signaturemeds

Hours of Operation

Monday                         9:00-4:00
Tuesday                         8:00-12:00
Wednesday                  9:00-4:00
Thursday                       9:00-4:00
Friday                            8:00-12:00

Sat - Sun                           Closed

Contact Information

Phone: 216-252-8000
Fax: 216-252-8117
Email: [email protected]
Address:  19050 Lorain Road
                      Fairview Park, OH 44126
  • Home
  • About
  • Contact
  • Forms