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Online Ordering Consultation Form

If you would like to complete an online consultation, please download this form and email it to us at: acuherb@acuherb.com.au

We will review your results and contact you with an appropriate prescription for your complaint.  

If you are ordering China Med or Black Pearl products, please complete the form and email it to us for us to complete your order. 
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Patient Information Form

If you are a new client and have a consultation booked at AcuHerb, you can assist us by completing this form prior to your first consultation.  Please download the form and print off the completed form to bring with you for your first consultation. 
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Consent Form

Please download and read this form prior to your first consultation or at any time you would like to review your agreement for treatment with us at AcuHerb. 

This form covers all the information you may need to know before your first treatment, things we would like you to understand about our treatment and undertakings AcuHerb makes regarding the safety and suitability of our treatment.  

If you want to discuss any of the information contained in this form, please call us on 03 5721 5807.
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AcuHerb - Acupuncture & Chinese Herbal Medicine

13 The Close, Wangaratta VIC 3677
Ph: 03 5721 5807
ABN: 99 759 199 494