Our forms are in Microsoft Word. Please fill them out and email back to us.
You can either keep a blank copy of the forms on your computer and save a copy for each new patient and/or prescription order. Or you can always return to this page for new empty forms.
KW Formulation Service Form
Please email a detailed and concise health history for your patient. Brian Kie Weissbuch L.Ac. will formulate and create an herbal fluid extract based upon the case history you provide.
Practitioner Prescription Form
Please type your unique patient Rx & email it to us as a MS Word document. pdf’s, handwritten, and other formats cannot be entered into our database! We will create your herbal formula as a fluid extract and ship this to you or to your patient via UPS.
PDF Index Files
download the Kw Single Herb Fluid Extracts, Latin Index
download the Kw Single Herb Fluid Extracts, Pin Yin Index
download the Kw Traditional Chinese Medical Formulas Pin Yin
Click on the download icon when the pdf page opens or just view it on the website. You will need acrobat reader or preview on a mac to view the pdfs.