Free Questionnaire

dr-lukeGet personalized advice directly from Dr. Luke who is a Doctor of Oriental Medicine, Licensed Acupuncturist, National Board Certified Chinese Herbalist, Master of one needle Qi-Gong acupuncture, and 7th generation Chinese Medicine Practitioner.

Please fill out the form below. Dr. Luke will respond via email regarding your recommendations.

Sex:

Tiredness?

How Do you Sleep?

Need to urinate at night:

Urinary Flow:

Frequent bowel movements?

Weakness or heaviness?

Please check all that apply:

How long have you had these conditions?

Do wish to use an herbal dietary supplement for any of the following?

Any other conditions that you would like Dr. Luke to address?

Have you taken New Vita products before?

If you answered yes, which products have you taken?

Have you seen any overall improvement?

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