For who has Covid-19/Fever/Cold/Flu symptoms and would like to take herb prescription from our clinic, please download those forms at bottom of this page.
如果您有Covid-19/flu 等呼吸道感染症状，并想由本诊所用中药方式治疗，可下载下列的表格填写。

Fill all information you can, scan or take picture of your files and send it back to here with your address/phone:
请尽可能填写您的资讯，扫瞄或将您的表格拍照寄email至本诊所的电子邮箱：

service@lightofheart333.com

If you are our client already, you can just download the Questionnaire.
如果您已经是本诊所的病人，您只需填写远距问诊单即可。

Also please text to (408)-837-1685 to let me know you have sent the request. I will review it and reply you the price. You can pay it through Paypal or Zelle by this email:

除寄电邮外，亦请text 至本诊所服务电话(408)837-1685，以确认我们有收到您的传档。我会检视您的状况并将您的科学中药价格回复给您。付款可透过 Paypal 或 Zelle，帐户为以下的电邮：

claim@lightofheart333.com

Once we confirm the payment, I will mail the herb prescription to you asap.

Thanks for your support!!

诊所收到款项后，即会透过邮局将药寄出。
谢谢您的合作！！

Please click this link to download these forms:
请下载下列的表格：

Patient’s information:
病人资料+Patient+Registration+Form

Legal document:
法律文件+Arbitration++Form+for+New+Patients+-+03-15-2014

Questionnaire:
发烧远距病人问诊单 Remote Patient Questionnaire 2020_04_08

If you are not have Covid-19/Flu type of symptoms but still need remote-diagnosis, please download this questionnaire. 
如果您并不是有新冠／流感的症状，但是需要远距看诊的朋友，请用以下的远距回诊单：
远距病人问诊单 Remote Patient Questionnaire