The Nyerongsha Institute

Please note: The office will be closed for spring break on April 10, and will re-open on April 17. Please place all your orders by April 5.

In case of an emergency, call 911, or visit the nearest hospital emergency room.

Patient Forms

If you are a new or ongoing patient of Dr. Dickey Nyerongsha, please feel free to download any of these PDF files for your personal use. Some are only required for your first visit.  Others might be needed again from time to time, depending on Dr. Nyerongsha's instructions. If you have trouble downloading a file, see "Downloading Tips" below.

New Patients

Please complete the following forms and take them to your first appointment:

Ongoing Patients

Herb Orders (patients only): Please use our Online Order Form for herb refill requests. If for any reason, you aren't able to use the online form, you can mail this printed version to the address listed on the form.

General Information

Use this information while continuing your personalized patient care plan:​​​
Downloading Tips
Click on the file you want. A new window will appear displaying the page. Right-click on the page and "Save As." You might get a message asking you where you would like to save the file. If so, select a location and continue.

As an alternative, you can look for the download icon (little page with a down arrow) at the top or bottom of the window. Click on the icon to download.

If it seems like nothing happens, and you don't see the file on your phone or computer, try the following:
  • Use the search function on your computer or phone. The file might have gone to an unexpected place.
  • If you're using Internet Explorer as your web browser, switch to a different application (Firefox, Safari, Chrome, etc.). Also, make sure your browser application is up to date. Older versions of web browsers often don't work properly with current websites.