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 等呼吸道感染症狀，並想由本診所用中藥方式治療，可下載下列的表格填寫。

Fill all information you can, scan or take picture of your files and send it back to here with your address/phone:
請盡可能填寫您的資訊，掃瞄或將您的表格拍照寄email至本診所的電子郵箱：

service@lightofheart333.com

If you are our client already, you can just download the Questionnaire.
如果您已經是本診所的病人，您只需填寫遠距問診單即可。

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:

除寄電郵外，亦請text 至本診所服務電話(408)837-1685，以確認我們有收到您的傳檔。我會檢視您的狀況並將您的科學中藥價格回覆給您。付款可透過 Paypal 或 Zelle，帳戶為以下的電郵：

claim@lightofheart333.com

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

Thanks for your support!!

診所收到款項後，即會透過郵局將藥寄出。
謝謝您的合作！！

Please click this link to download these forms:
請下載下列的表格：

Patient’s information:
病人資料+Patient+Registration+Form

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

Questionnaire:
發燒遠距病人問診單 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. 
如果您並不是有新冠／流感的症狀，但是需要遠距看診的朋友，請用以下的遠距回診單：
遠距病人問診單 Remote Patient Questionnaire