ACMA Support Forms

ACMA New Patient Form

(Condition Form)

This form is required for all new patients.  Please complete it (type or print) in details and bring it with you during your first appointment.

This form has two formats: Word and PDF.  You can use either one.

ACMA Update Form

This form is for current patients to report conditions after taking ACMA herb.

Visit Patients: Please email this form 1-2 days before next appointments.  Without this form, your new herb cannot be prepared, you will not be able to pick up your herb at your appointment, and you will have to come back the following day to pick your herb.  So this form can save your time and trip.

Tele-Support Patients: Please email us this form several days before finishing current herb.

After submitting your form, if you have not heard from us, it means we have received your form and everything is fine.  If we need additional information, we will contact you.

This form has two formats: Word and PDF.  You can use either one.

Allergic Reactions

When starting a new ACMA herb or changing to a new ACMA herb, some patients may get allergic reactions. Allergic reactions are not dangerous and can be quickly cleared if you stop the herb and call ACMA asap. ACMA has many methods that can quickly stop the allergic reactions.

After taking ACMA herb, if you have allergic reactions (any symptoms you did not have before taking the support), please stop the herb and call ACMA asap.

If you have any questions, please contact us asap.