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Lesley Tierra is a California state licensed and nationally certified acupuncturist and herbalist. She has a practice in Santa Cruz, California where she combines acupuncture, herbs and food therapies along with lifestyle and inner growth counseling. She is a founding and professional member of the American Herbalists Guild.

Print using the print icon at the top of this page and fill out the intake form below. Fax your completed form to (831) 429-0103 with your credit/debit number and date of expiration. You may also copy and paste the intake form and This email address is being protected from spambots. You need JavaScript enabled to view it. The fee is $150 per incident. Cancer consult fee is $250. For telephone consultations call: (831) 429-8066 to make an appointment. Students currently enrolled in the East West School of Herbology receive a 20% discount on fees, mention that you are a student when you make your appointment.








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Philosophical or religious affiliation (optional):

How or from whom did you hear about us?:

Medical doctor or other practitioner:

Please list all medications, including herbs and vitamins you are presently taking, or therapies you are presently undergoing:

Have you ever undergone herbal therapy before?

Do you generally respond well to medical treatments, medicines, therapies, etc.?

A. PRIMARY COMPLAINT -- (Describe your symptoms to the best of your ability):


B. SECONDARY COMPLAINTS --- (List any other symptoms you are experiencing regardless of whether it seems related to your primary complaint):

When did you first notice it? A __________ B __________

How long has is been occurring? A __________B __________

When and under what circumstances does it seem to improve? A __________B __________

Have you been treated by anyone else for this condition? A __________B __________

If so, when and by whom?

Medical History (List all past illnesses, injuries and operations):

Medical History of Relatives (Briefly):

Grandparents, parents, Aunts/Uncles, Siblings, Children

Blood Type?

Ancestry? (What part of the world your parents/grandparents lived):

Basal Temperature: (Take your temperature three mornings in a row, before rising, record average)

Pulse Rate:

Indicate if you have experienced any of the following conditions: If you have in the past, use a P, if recently use an R, if frequently also include an F.

_____HBP _____Hypoglycemia _____Low Body Temp.
_____LBP _____Epilepsy _____Gallstones
_____Heart problems _____Nervous Complaints _____Kidney Stones
_____Shortness of breath _____Spasms/twitches _____Hepatitis (specify type & dates)
_____Asthma _____Bloatedness _____Carcinoma (specify location)
_____Allergies _____Sleepiness after meals _____Cancer (specify location and type)
_____Sinus infections _____Enlarged lymph nodes _____Low back pain
_____Headaches _____Enlarged spleen _____Frequent urination
_____Frequent colds & flus _____Enlarged Liver _____Night time urination
_____Poor memory _____Mononucleosis _____Teeth problems
_____Cold Hands and Feet _____Hearing Difficulties _____Thyroid Problems (specify)
_____Undigested food in stools _____Constipation _____Eyesight difficulties
_____Loose stools _____Depression _____Glandular problems (specify)
_____TB _____Over-excitable _____Mood Swings
_____Anemia _____Diarrhea _____PMS
_____Diabetes _____Tight neck/shoulders _____Disability of hips
_____Disability of back _____Disability of knees _____Disability of ankles
_____Other (specify)

For Women:

What is the length of your menstrual cycle?

What is the length of your menses itself?

Do you ever experience PMS? Cramping? If so when? Clotting? Light flow? Excessive flow?

List the dates and years of any children you have birthed and if they were normal delivery:

For Men and Women:

How would you describe your energy level?

High ___________ Low ___________ Up and down ____________

How would you describe your sex drive?

High __________Low ___________ Up and down ____________

Do you get gas and/or bloatedness?

How would you describe your elimination?

Bowel Movements: Are they regular (daily) ___________ Consistency and color: ______________

Do they float or sink? __________ Mucus in the stools? _____

Urine: Is your urinary frequency more than 6x/day or less than 4x/day?

Color __________Odor ______________ Other __________ _________

Do you experience night time urination? Number of times/night?

How would you describe you sleep?

Any recurring dreams?

How is your memory?

How would you describe the stress level in your life? Home _________ Work ___________

Other ______________

Do you have an unusual susceptibility to heat or cold?

What temperature do you prefer in terms of climate and foods?

What is (are) the predominant emotion(s) you experience?

Are you content with your life? Home? Work? Social? Other?

What are your strengths?

What are your weaknesses?

Please describe any emotional issues you have in terms of your family, work and social relationships:

What special ambitions or desires do you have?

Do you use alcohol, cigarettes, cola, sugar coffee, marijuana, cocaine or any other recreational drug? (specify frequency and quantity):

Would you consider yourself to have a sugar, caffeine, nicotine or drug addiction?

Do you have a strong preference for, or aversion to, any foods or drinks? (specify):

What particular diet or nutritional program do you follow? (Example: vegetarian, macrobiotic, meat & potatoes, etc.)

Do you generally cook your own food?

Where do you shop for your food?

Please describe your general diet:






If possible please send the following photos, which are very helpful towards your evaluation:

Email a photo of yourself (mostly your face) and a photo of your tongue. If you do not have the technology to email the photos please mail them to:

East West Acupuncture Clinic, 912 Center St., Santa Cruz, CA 95060

How safe is acupuncture and is it painful?

The needles used in acupuncture at the East West Clinic are absolutely sterile, strictly disposable and extremely smooth and fine. This makes for the least amount of sensation upon insertion. In fact, in most cases patients comment that they hardly feel anything at all when the needles are first inserted. The fear of needles can be understood because when it comes to the all too familiar injection of much larger, thick and hollow hypodermic needles that are used in conventional western medicine. However, acupuncture needles are usually extremely fine and rather than piercing the skin, their cone-like engineering actually causes the surface skin cells to gently and painlessly spread and open. This means that far less or no sensation associated with what we commonly understand as pain.

This being said, after insertion, depending on the tolerance of the patient, in the interests of offering the most effective treatment, the acupuncturist will gently manipulate and twirl the needles to achieve a peculiar neurological sensation called 'da qi' or 'big qi' by the Chinese. This can have a range of mild sensations from dull, heavy or traveling. This is hardly identified as 'pain' by the patients who receive acupuncture. In fact, because it has a feeling of freeing up congestion and pain, a patient can have the feeling of reaching a level of desired satisfaction and relief with acupuncture.

At the East West Clinic, the patient is always encouraged to be fully present with a sense of control over what is being offered. If a sensation is too strong or insufficient, he or she is reminded to tell the practitioner so that the treatment can be adjusted to their individual needs.

One of the most common responses during and after most acupuncture treatments is a sense of relaxation and ease that signifies a healing response. In fact, it is not uncommon for patients receiving acupuncture to drift off into a pleasant state which we at the East West Clinic jokingly call "acu-land."

How long does one need to undergo treatment ?

This depends on many factors such as the prognosis and duration of the disease. Generally for minor acute problems one to five visits are normal. For more complex conditions, one would should expect a minimum of 10 visits and then reassess the rate of progress. The more chronic conditions will require treatments over a prolonged period to achieve complete healing. While it is not a hard and fast rule, we often tell our patients that they should expect to undergo treatment for at least one month for every year they have been experiencing a specific chronic condition. However, in most cases, relief is forthcoming within the first ten sessions.

Should one have herbal and acupuncture treatments while taking western conventional medical treatment and drugs?

Usually there is no problem because both systems of medicine work at a different level and when used in this way, are highly complementary with each other. In some instances, the use of certain drugs, especially those that affect the nervous system will compromise to some extent, the effects one's response to acupuncture. Also, drugs that have a direct effect on the endocrine system such as cortisone-like drugs will alter one's response to certain herbs. However, an altered response does not mean no response and patients will always receive some benefit from the concomitant use of acupuncture, herbs and dietary therapy even though they must simultaneously use conventional medicine.

The drugs are usually intended to treat the more superficial symptoms while the herbs and acupuncture work on the underlying causes.

Are treatments covered by Insurance, HMO's or governmental entitlement programs?

Many insurance companies and entitlement programs now cover acupuncture. The East West Clinic can provide patients with forms to bill their own insurance companies themselves, but does not directly bill insurance companies.

Routine Conditions

Conditions that are routinely treated at the East West Clinic:

  • common colds and flus
  • gynecological imbalances
  • neurological diseases
  • depression and anxiety
  • insomnia
  • metabolic diseases
  • upper respiratory diseases
  • digestive problems
  • arthritic and rheumatic conditions
  • sciatica and lower back pain
  • fibromyalgia
  • supportive cancer care
  • skin diseases
  • weight control
  • stop smoking
  • detoxification


"If I had my way I'd make health catching instead of disease." -- Robert Green Ingersoll


Acupuncture is part of a 5000-year-old system of healing which, along with herbal, dietary and lifestyle adjustment has evolved as a part of Traditional Chinese Medicine. Based on restoring the balance of Qi (vital energy) throughout the various organ meridians, acupuncture has come to be widely accepted and recognized in the West as a powerful and economical treatment for many diseases. Acupuncture is increasingly supported by a number of governmental and private insurance providers.

Besides the use of needles, acupuncture includes many additional external therapies as part of Traditional Chinese Medicine. Some of these that are routinely incorporated appropriate to the individual needs of each patient are as follows:


This involves the use of an herb, mainly artemisia vulgaris. The dried 'wool' of this herb is burned close to specific acupuncture points. This method is essential for the treatment of hypotonic conditions caused by coldness and deficiency and is highly effective. Moxabustion is highly effective for stimulating the immune system, promoting circulation, adding vital energy directly into the meridians and neurological pathways of the body and relieving pain. In most cases the experience is highly pleasurable and, like acupuncture, induces a state of calm relaxation in the patient. Occasionally, but very rarely, a patient may develop a burn or blister from the treatment. Because the treatment is often quite pleasant and relaxing, this result may not always be predicted by either the patient in their response or the practitioner. While burning and blistering is generally not intended, without previous consultation with the patient at the East West Clinic, it sometimes, though as stated, very rarely occurs. As a point of information, in China a strong moxabustion treatment often involves intentionally burning and blistering a particular point or area for the treatment of stubborn diseases. Interestingly, again in China, when a blister occurs it is controlled but allowed to stay open and festering for awhile to further stimulant an even deeper, more prolonged immune response.

Needle-less Acupuncture

At the East West Clinic this can involve the integration of many modalities ranging from the practice of acupressure, the use of gentle non-piercing devices as part of what the Japanese call Shoni-Shin or Pediatric acupuncture. It may also involve the local application of magnets, herbs or a special magical acu-powder that is topically applied over selected acupoints. Acupuncturists also often use a small hammer-like instrument, called a Seven Star Dermal Hammer. This is lightly tapped over affected areas to stimulate the circulation of Qi (vital energy) to many conditions ranging from aches and pains, skin conditions, the cosmetic removal of wrinkles and unwanted stress lines on the face, to stimulating the growth of hair.

Cupping and scraping

This is part of Chinese folk medicine and the folk medicine of many people throughout the world. It is also used in the practice of Traditional Chinese Medicine. Cupping involves creating a vacuum in a small, bamboo, glass or plastic cup which is then applied over more general areas such as the back, neck, limbs or abdomen. Scraping, called "gua-sha" by the Chinese involves scraping specific areas of the skin with a dull edged instrument such as a piece of jade or the edge of a Chinese soupspoon. A special healing oil is first applied to lessen discomfort. At the East West clinic we have found this to be immediately and highly effective for various conditions, especially stiffness and pain of the spine and neck. It is one of the treatments of choice for one of the most common traumatic injuries, neck whiplash. Both cupping and scraping are used to relieve underlying congestion of the tissues, promote circulation and relieve inflammation and pain.

Magnet Therapy

Being in the forefront of some of the most cutting edge natural healing modalities, magnet therapy is a specialty of the East West Clinic. In fact Michael Tierra has written an entire book on the subject entitled Biomagnetic and Herbal Therapy (published by Lotus Press). Many patients come to the clinic to specifically receive magnet therapy. They have been satisfied with the fact that this powerful yet safe therapy has in many instances provided instantaneous painless relief of a wide range of problems ranging from carpal tunnel, tennis elbow and other repetitive stress injuries. In addition, magnet therapy is used for back pain, chronic fatigue, inflammatory conditions of all kinds, ulcerative colitis, back pain, injuries, arthritic and rheumatic diseases, to name a few. Magnets have even been found to be effective in shrinking tumors. Michael Tierra has extensive use in the practice of magnet therapy and applies them in many ways according to the individual needs of the patient. Magnet therapy often offers more immediate relief of pain and inflammation than the use of needles. Magnets not only give immediate relief but when used over a period of time, work by promoting and normalizing circulation and therefore promote permanent healing. Magnet therapy is highly effective for sports-related injuries.

In 1997, Michael was interviewed on the popular national TV show, Inside Edition on his highly effective use magnet therapy.


This is a method where a safe, mild electrical impulse is directly applied to specific needles that have been previously inserted. Again, this is not necessarily painful but can be indeed a very strange sensation as it alternatingly causes an associated neurological reaction. This is commonly used to make a stronger, more prolonged treatment. It is very effective for muscular, tendon and skeletal pains.

Herbal Medicine

Michael Tierra is regarded as one of the pioneer fathers of the herbal renaissance of the late 20th century. As such he has inspired and taught herbal medicine to literally thousands of students throughout the world. These include both laypersons as well as professional health practitioners. His book, The Way of Herbs (published by Pocket Books - Simon and Schuster) has sold over 400,000 copies and is translated into many languages and published in many countries throughout the world. Michael is the founder of the American Herbalists Guild, a professional organization of clinical North American herbalists, representing the highest standard of herbal health care.

Next to diet and lifestyle changes, herbal therapy is offers the deepest and most permanent healing for most conditions. It can be safely used alone or win combination with many other modalities including acupuncture and conventional western medicine.

Herbal medicine is truly the first medicine of humankind. Indications of the use of native plants for medicinal healing have been found to date back over 50,000. Many of the same herbs, often regarded as wayside weeds, such as dandelion, plantain and chickweed are still used with great therapeutic effectiveness by herbalists today. Throughout the world, herbs have a well-deserved reputation for their safety and efficacy.

It can be reasonably argued that the major reason they are not more widely used is based more on economic reasons because they are not patentable as a drug by multi-billion dollar pharmaceutical companies. In the hands of experience and skilled herbalists such as Michael and Lesley Tierra, herbs can be safely and effectively used to treat all conditions and diseases.

Michael and Lesley are equally skilled in the practice of western and Chinese herbal medicine as well as East Indian Ayurvedic medicine based on herbs. Besides the use of herbs, the practice traditionally includes the use to a much lesser extent of minerals and ecologically conscious animal sources for medicines.

The East West Clinic is one of the few that carries a full line of Chinese, Western and Ayurvedic herbs and formulas. Besides dispensing herbs as teas, other preparations are even more commonly used such as pills, alcoholic tinctures and extracts and dried extracts. In most cases, herbal formulas are specifically compounded according to the condition and constitution of each patient.

Patients literally travel from throughout the world to be guided in the use of herbs for their personal health issues. In addition, Michael and Lesley offer specialized telephone consultations with patients and practitioners for the treatment of various conditions and diseases.

We are proud of the fact that the East West Clinic is now recognized in the forefront internationally of herbal research and practice.

Dietary Therapy

"Let your food be your medicine and your medicine, your food" These are the words of the Greek sage, Hippocrates, called the Father of Medicine. They are true no less today than they were nearly 3000 years ago. Increasingly medical researchers are finding that dietary and environmental conditions are at the base of many if not most diseases. While a diet with too many excesses can cause chronic degenerative disease, extreme so-called health diets are also responsible for creating long-term nutritional deficiencies. For this reason, those who are able to incorporate the dietary modifications recommended at the East clinic are most likely to experience the fastest and most permanent results. "To eat is human; to digest, divine." --- C.T. Copeland

Dear Michael
A little note to say "thank you" for the wonderful new life you have led me to.Last year I was under treatment for severe rheumatoid arthritis, the pain was constant. Most of the time I could hardly walk, couldn't use my hands, I was 30 pounds overweight for years. I was given numerous drugs all with very dangerous side effects, the result seemed to be a progressive and deepening depression and feeling I just wanted to die.

I am a very rigid and conservative Christian and had really been praying for a healing or to be led to someone who could help me. One day a friend I came to see me and mentioned your book "The Way of Herbs". I read it and was very impressed. I then called and made an appointment. I had to wait 2 weeks. The same morning had the appointment with you, I got a biopsy report telling me it I had cancer. The medical doctor had me all set up for various treatments. I was in a state of shock. I left his office and went directly to your office. You talked to me about diet, attitudes and things no medical doctor ever bothered to mention. At that point, I really feel the Lord spoke to me and I made the decision to abandon all conventional medical treatment and go for what you suggested. That was the beginning of many miracles in may my life.

I immediately started with the herbs, weekly acupuncture and the macrobiotic diet. The first miracle was that within a week, the arthritis was much better. In 5 months it was gone plus 70 pounds of fat. As far as I know, the cancer is gone too. The most important changes are those within,, as my body healed so my spirit . I will never be the same (Thank God!). I have not arrived nor will I ever these changes and new things come to me every day this is a lifetime Journey, not a final destination nor place I will over arrive at. My work with the Lord is closer than ever and you, Michael are the channel that he chose to reveal some of the changes I had to make. During the early days of treatment, many times I was discouraged and fearful, in those times you gave me the gentle guidance I needed and when necessary you let we know that I am responsible to study and do what I need to help my body heal. I really don't have the words to express the gratitude I feel. Thank you Michael for showing me the way. I feel and look better than I have in 30 years.

With much love,
R. Joan Morris (Santa Cruz, Calif., 1983)

Four years ago, I was diagnosed with a potentially life threatening kidney disease. Western medicine held not much hope except the slow decline of kidney function and future transplant. Since I am opposed to invasive procedures and the compromise of the immune system this was not acceptable to me.
'I turned to Dr. Tierra and found what I was looking for and needed. With much patience on his part and a lot of changes and work I am so excited to say that I have barely lost any kidney function in these past four years.
'In this time Michael has also helped with many other health problems, and I look to him as my major health care provider. During these years I have seen people travel from all over the world to come to his clinic. I have also seen him send many students out into the world to extend the healing.

I recently treated myself with your herb tonic for the liver. I had hepatitis and my personal physician was certain that I would remain a carrier of surface antigens, but was completely surprised at my full recovery. Thank you for your inspiration.

I have been using your Planetary Formulas on my 5 year old daughter who is Autistic. The formula Calm Child...has helped my child calm down and she is able to concentrate for the first time she has been using it for 8 months and she is already doing well in school. She doesn't speak but she signs well, and her art work and math and reading skills went up. ... Your product has given my daughter a chance on life.

I was told my my doctor that my liver was at such an advanced state of cirrhosis that I should expect a liver transplant within a year. After consulting you and taking your herbs, especially Bupleurum Liver Cleanse, I returned for another blood test and all liver functions were within normal range. Thank you.

I was diagnosed with terminal pancreatic cancer. The medical doctors at Kaiser offered a bile resection to alleviate any discomfort as my body moved closer to death. The prognosis was 2 months. I decided to not go along with the prescribed operation and work with you, taking your herbs and receiving weekly acupuncture treatments. It has been over a year and a half. A few months ago I went for another check up and they could find no indication of the cancer. I continue to take your herbs and see you now about once a month. On behalf of my entire family, I thank you!

I was diagnosed with terminal breast cancer. I already had a mastectomy on one breast but there was a hardened mass of cancer and scar tissue that extended from the area of the left breast to the shoulder. Since I refused chemotherapy, my medical doctors had nothing more to offer me. It has been nearly 10 years, I have completed my degree in psychology and continue following the macrobiotic diet and herbs you recommended. The mass remains but thank God, I am still alive.

I am in my mid 40's and have been diagnosed with a rare case of hemosiderosis (bleeding from my lungs). The disease leaves me feeling weak, anemic and consequently unable to work most of the time. I have mostly refused any conventional medical intervention feeling that it would further compromise my immune system. Except with occasional flare ups, the acupuncture treatments and herbs that I receive and take each week has been able to completely control all my symptoms. I have little or no episodes of spitting up blood and longer periods of sustained energy.

Since childhood, I have suffered from chronic asthma and emphysema. I am now in my early 50's and the problem persisted, limiting my level of activity. As a result I have been on disability for 4 years. Even after the first visit where you applied needles and burning an herb close to the skin on my back, the symptoms have lessened dramatically. Thanks to you I hardly ever have to use the inhaler prescribed by my doctor.

I came to you for a severely red face for which medical doctors and dermatologists had nothing to offer. You painlessly applied fine needles to a number of points on my face and legs and gave me a Chinese herbal formula. All my symptoms cleared up within the first week after treatment.

I am a woman, age, 33. I have been suffering from bi-monthly outbreaks of genital herpes simplex. Needless to say, this has severely impeded my ability to have a decent relationship with a man. You told me to stop all foods with sugar including fruit juice, coffee, marijuana and other recreational drugs. You also advised a diet based on whole grains, vegetable protein supplemented with fish. You also administered weekly acupuncture treatments for about three months and during that time prescribed a Planetary formula (HerbaDerm) and a tea to take daily. At first, my symptoms occurred with less frequency and less severity. Gradually this continued to progress until now, six months later, I have not had a herpes outbreak for two months straight and happily I am beginning a relationship with a man who I like very much. Thank you from the bottom of my heart.

My husband and I were trying to have a baby for over three years. We were both checked and the doctors could find no reason why I could not get pregnant or the two times I evidently did become pregnant, I miscarried at around the third month. I underwent a series of acupuncture and herb treatment with you over the course of four months and finally became pregnant again. I continued to see you for treatment twice a month throughout my pregnancy and you gave gentle acupuncture and herbal treatments. Thanks to my husband and your gentle assistance, I now have a healthy 4 month old baby boy.

The following are some cases treated at the East West Clinic.

Knee pain and diabetes

Patient Man, AGE 67, 4/14/93
Symptoms Right knee pain, recently diagnosed with diabetes
Observations Pulse: slippery, hollow, deficient spleen, weak kidney pulse, Tongue pale, thin yellow pulse, scalloped
Diagnosis spleen and kidney qi deficiency with dampness and Bi pain of the right knee.
Treatments shih Chuan Da Bu Wan
Acupuncture: eye of the knee for left, 2 emperor for diabetes.
Comments By second visit, knee completely recovered, feels great

Cholecystitis and asthma

Patient Woman, 4/22/93
Symptoms Gall bladder pain, doctors found a hiatal hernia, pain is aggravated from fats and oils, stabbing, stinging pains, pain under the right ribs from middle to far right, pain goes away with grape juice, trouble losing weight. Has severe asthma.
Observations Damp heat in the gall bladder
Treatment Stone Free, Turmeric root 1 tsp., 3x daily, Tea Oregon Grape, wild yam, fennel seed. three cups daily, Sylamarin extract, Triphala.
Comments Second visit 7 months later: all gall bladder symptoms are gone.

Chronic Fatigue

Patient Man, 4/15/93, age 66, bachelor, retired
Symptoms A lifetime of chronic fatigue, as he gets older it is worse, he has had 5 heart bypass surgeries with dials in two leg arteries. Shortness of breath, extreme fatigue, feels that he doesn't have long to live. He even welcomes death. Frequent urination, bad memory, likes sweets, Smokes tobacco and marijuana, drinks a quart of coffee daily, takes lasix. Never cooks his own food, eats out a lot, cheap junk food.
Observations Pulse: deep, irregular, fast
Tongue: reddish, little or no coat, cracked
Diagnosis stagnation of the liver, blood toxicity, deficient qi.
Treatment Principle: relieve liver qi and blood stagnation, ease heart circulation, tonify original qi
Acupuncture: St. 36, deep; two emperor
Herbal: life pulse, Guggul, Reishi supreme, Bupleurum Liver cleanse.
Comments Recommended that he prepare all his own food or get someone to do it for him. Recommended a balanced diet generally but to begin with kicharee fast of ten days or use whole grains and beans.
Second visit: He came in cleanly dressed and said that it was the first time in his life that he had experienced energy and normalcy. He only did kicharee for four days.

Liver Failure and cancer

Patient Man age 53, unmarried, self employed hair dresser
Symptoms Diagnosed with liver cancer (advanced). Also had hepatitis C from blood transfusion, hard bloated abdomen, and surgery 7 weeks ago.
Observations Extreme ascites. Pulse fast, fuller on the surface, hollow in the deep position, kid, Liv and spleen were deficient. Tongue: red, peeled in the center. Diet O.K. , No sugar, no coffee, no alcohol.
Diagnosis Liver and kidney yin deficiency with wasting heat.
Treatment Herbs: coptis and Scute, Reishi Supreme, Hepato Pure, Triphala, Blood Purifying Tea, Selenium, Vit. c, Beta Carotene, Seaweed. Acupuncture: 4 gates, kid 3. Also gave him Wu ling san for the ascites (biggest problem).
Comments Gave him four treatments. He was too advanced. He was committed to the hospital and died of liver failure.

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