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 ( 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.

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