Online Patient Consultation Form

In order for us to prescribe you with our custom made herbal tea, you need to have a consultation with us and fill in our Online Patient Consultation Form. You can download the form, fill it out and please send it back us via email (mcaahltd@hotmail.com) or WhatsApp (07584130688).

We recommend that you contact our clinic and have a free consultation with one of our therapist before filling this form out.

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We have an English version and a Chinese version of the form. 

Online Patient Consultation Form- English Version

Online Patient Consultation Form (问诊单)- Chinese Version (中文版)