Online Herbal Consult

Existing patients can submit the form below to describe acute symptoms (cold/flu/allergies) and receive an herbal prescription without coming in for an appointment. If you are new to Shift Acupuncture, please make an appointment for an in-person Herbal Consult first.

$10 consult fee, plus cost of herbs (ranges from $15-30).
Payments are made via Venmo, Paypal, or other arrangements - your practitioner will request the payment.  Prescriptions can be picked up from Five Flavor Herbs

We will send your prescription to Five Flavors within 24 hours of receiving your form.  Please note: if you submit your form on Saturday afternoon or any time Sunday, your prescription will not be ready until Monday.

Name *
Name
Phone *
Phone
When did the symptoms start?
When did the symptoms start?
Symptoms
Check as many as apply
Include remedies you have tried and their effect.
Quality (sharp, dull, throb, etc). Where on your head or face? Intensity?