Home   
  Services/Treatment     Location/Map      Insurances Accepted     Forms     Publications    Time Management/Productivity Tools     Disorders 


 

 

FORMS
(No access to a computer?  Just stop by our office and we will supply you with a copy.)

All Insurances, including Tricare and Military (Except Med-Cal):

Please download, print, and complete the appropriate PDF File and bring the completed forms with you for your first visit to Dr. Karman's office.  Don't forget to bring your insurance card with you so Elizabeth, our Office Manager, can make a copy for your file.  Also, if your insurance is Tricare or military, we will need the sponsor's social security number and birth date.  If the patient is an adult, complete the Adult Intake Forms.  If the patient is a child, complete the Child Intake Forms.

Medi-Cal Patients:

To better serve you and to help streamline our office procedures, we are providing below the forms Medi-Cal and HIPPA require you to complete and sign.  Please download the PDF files, print, and complete at your leisure.  If the patient is an adult, complete the Adult Intake Forms.  If the patient is a child, complete the Child Intake Forms.

After the forms are completed, just drop them off at our office.  Elizabeth, our Office Manager, will then make a copy of your Medi-Cal card and schedule your appointment.

Medi-Cal Adult Intake Forms - PDF
Medi-Cal Child Intake Forms - PDF

   
Click On Icon to D
ownload Free Zip File Opener

 



57402 Twentynine Palms Highway, Suite 10  -  Yucca Valley, CA  92284
 Office:  (760) 418-5997
FAX:  760-820-1094
 E-Mail:  bkarman@gmail.com

PSY 9274


Dr. Robert N. Karman Psychological and Counseling Services:  Web Design, Maintenance, and Copyright
 Dr. Robert N. Karman Psychological and Counseling Services:  All Photographs and Artwork Copyright