To schedule your office visit, simply fill out the Consent for In-Person Medical Office Visit form and the two-page Registration Form and Health History below. Scan, then email completed forms (with no more than 6 pages of lab results) to: Julie@pmcmarin.com OR if email is not possible, then Fax your completed forms (with no more than 6 pages of lab results) 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. Shames. NO MEDICARE BILLING OR REIMBURSEMENT IS POSSIBLE.
Consent for In-Person Medical Office Visit with Dr. Richard
Shames (Please send or fax this to our office)
Two-Page New Registration Form and Health History Fill out now and email or fax to office
Two-Page Patient Welcome Letter -- For your information
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. Richard Shames is a Harvard and University of Pennsylvania educated practicing MD who specializes in optimal hormone balancing, especially individualized thyroid care.