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traditional chinese medicine
808-652-0381

Intake Form

If you want to give me a head start on helping you, please fill out the intake form and hit “submit” at the bottom.  Mahalo!

 

New Patient Form

  •   Asthma
      Alcohol or drug abuse
      Cancer
      Diabetes
      High blood pressure/ Cholesterol
      Heart Disease
      Hepatitis
      HIV/ AIDS
      Mental disorder/ Emotional Trauma
      Multiple Sclerosis
      Stomach Ulcers
      Stroke
      Thyroid Discorder