Here you can find the forms necessary to begin your diagnosis and treatment, or order herbal prescriptions.
	On-line Diagnosis Request & Herbal Prescriptions
	We apologize, but the online diagnoses requests have became too numerous and Dr. Lewis was unable to personally communicate with each patient who requested an evaluation and herbal prescription. Therefore, Dr. Randine Lewis is no longer conducting online evaluations through this site.   If you are interested in utilizing her Fertile Soul Advising Service, please go to www.fertilityretreats.com/fertility_advisors.htm. A thorough TCM evaluation and herbal treatments are available through this offering. You will be scheduled for weekly or ongoing telephone conferences throughout your subscription to this service.   Available mid-July, 2004.
	Downloadable Forms Below are links to forms that you can download, print, and fill out. You can then either fax or mail the forms to the clinic to provide information for an appointment, or place an order for an herbal prescription. The forms listed below are set up as Portable Document Format (pdf)* files. To view and print these files, you will need the FREE Acrobat Reader browser extension or application from Adobe. See below for a link to download Acrobat if your browser does not already include this extension. Please note: clicking on the links below will open a new window to load the form and/or launch the Adobe Acrobat Reader application. This window will remain open behind the new one. If a new window does not open, and you are asked to save the file, then you do not have the Adobe Acrobat Reader plug-in installed for your browser. Installing the plug-in (see below) will allow you to view and print all PDF files directly from your browser window. If you have any trouble downloading and printing our forms, they are also available at our office. You may either pick them up, or contact us by phone or email if you would like them mailed to you, or fill them out at our office before your first visit.
	Complete set of forms for Women Patient Information Medical History Health History Women's Fertility History ehformsf.pdf Complete set of forms for Men Patient Information Medical History Health History Men's Fertility History ehformsm.pdf Separate Forms Patient Information Form ehformpi.pdf Medical History Form ehformmh.pdf Health History Form ehformhh.pdf Men's Fertility History Form ehformmf.pdf Women's Fertility History Form ehformff.pdf Women's Body Temperature Form bbtlongf.pdf
	*Requires Adobe Acrobat Reader Download FREE here
	HOME ACUPUNCTURE HERBS FERTILITY PMS MENOPAUSE DIAGNOSIS MEDICAL ARTICLES SUCCESS STORIES ABOUT US LOCATION If there is no menu bar to the left, load the FRAMES VERSION. CALL FOR APPOINTMENTS Eastern Harmony Acupuncture & Herbal Clinic Phone: 713/529-1610 4611 Montrose Blvd, Suite A201, Houston, TX 77006 (See Map)   email: info@easternharmonyclinic.com © Copyright 2003, Eastern Harmony Medical Acupuncture Clinic - All Rights Reserved. Web page design by Tim Hansford. email: timhans@swbell.net Wed site maintained by WebIT Creations