Getting Started


At PMCM we believe that “Your Health Starts with YOU!”

Welcome to PMCM. We want to make this as simple as possible for you to have great health care and support your well-being.  In order to save you time and prepare us both for your visit, follow these easy steps so that we can begin to serve you:

  1. Call our office at 415-213-2249 and speak with our front desk staff about your first visit.
  2. Locate the right forms for you to fill out based upon the practitioner you will see.
  3. Fill out the forms, ideally before you arrive for your first appointment–this facilitates your visit and makes it more efficient and effective.
  4. Enjoy your visit to review and improve your health.
  5. Let us know if you have any suggestions to improve your visit.
  6. Make sure you ask about fasting for a morning appointment should you want your blood tests done.

Health Forms

Download these forms and bring them with you filled in for your first appointment.

The PMCM Patient Registration and Health History forms are fillable pdfs so you can also complete them online and send them to the clinic via this private secure email-

PMCM Patient Registration

PMCM Patient Health History

Form for Dr. Tom Reece

Form for Dr. Richard Shames

Form for Holly Edson NP

PMCM Welcome Letter


PMCM Health Profiles

Once you have scheduled your appointment, fill out the health profile forms above and bring them to your appointment. This is a Personal Health History Form that Dr. Haas has used in his medical practice for more than 30 years. It includes a standard medical review plus lifestyle questions and nutritional habits as well as exploring, exercise, stress and emotional issues. It helps us to more easily assess the general health status of our patients. Even in the event that you are not intending to become a patient of Preventive Medical Center of Marin, this form will provide you with unique insight about your health and health habits and may even motivate you to make some improvements.


Preventive Medical Center of Marin

4340 Redwood Highway, A-22
San Rafael, CA 94903
Phone: 415-472-2343
Fax: 415-472-7636

Office Hours

Get in touch