In-Office Healing Sessions with
Karilee Shames PhD RN
To schedule your office visit, simply fill out the
Consent to In-Person Medical Office Visit Form below. All
lines must be filled in, including witness signature AND
primary physician information in order for this form to
be processed. Fax it to: 415-472-7636. Then call 415-472-2343 between 9am-5pm (PST) to schedule a Wednesday/Thursday in–person office appointment in San Rafael, or Tuesday in Cotati with Dr. Karilee Shames. NO MEDICARE BILLING OR REIMBURSEMENT IS POSSIBLE.
to In-Person Healing Session with Dr. Karilee
Profile - after scheduling your appt, download, fill out
this form, and bring it with you to your initial appt.
Our forms are in Adobe Acrobat .pdf format and can be
read/printed using Adobe Acrobat Reader. A free copy of Adobe
Acrobat Reader can be downloaded here.
Dr. Karilee Shames
is a Certified Clinical Specialist in Psychiatric Nursing
and in Holistic Nursing. Read
more about my practice.