Online Patient Information Form

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

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

Online Patient Information Form- English Version

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