To schedule your office visit, simply fill out the the forms below.
Scan, then email completed forms to the scheduling coordinator. Dr. Shames has two locations from which you can choose to meet with him. Inform the scheduling coordinator of your preference. The email address to send completed forms is:firstname.lastname@example.org
Scheduling Coordinator for Dr. Richard Shames OR if email is not possible, then FAX your completed forms to:
Then call 415-472-2343 to schedule your desired time of appointment and location.
|In-Person Medical Appt||DAY||LOCATION|
|9:30am-12:00 pm (PT)||TUE||Cotati Medical office in COTATI, CA|
|9:30 am-4pm (PT)||THUR.||PMCM Medical Office in San Rafael, CA|
IMPORTANT: NO MEDICARE BILLING OR REIMBURSEMENT IS POSSIBLE.
Consent to In-Person Medical Office Visit with Dr. Richard Shames (Please email a scanned copy or fax this to our office).
Two-Page New Registration Form and Health History Fill out now and email a scanned copy, or fax to office.
Two-Page Patient Welcome Letter Read and then keep 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.