Get Hk New Territories West Cluster Medical Report And Patient Information Application Form 2022-2025

Filling out the HK New Territories West Cluster Medical Report And Patient Information Application Form online is a straightforward process. This guide will provide you with a clear, step-by-step approach to ensure that you complete the form accurately and efficiently.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to access the application form and open it in your preferred online editor.
2. Select the hospital you are applying to by checking the applicable box under the ‘To’ section. Only one hospital should be selected. Options include Tuen Mun Hospital, Pok Oi Hospital, Castle Peak Hospital, Siu Lam Hospital, and Tin Shui Wai Hospital.
3. Fill out the ‘Details of Patient’ section completely. Provide the patient's name in English and Chinese, the HKID or passport number, sex, date of birth, address, and contact information.
4. Indicate the number of reports or certificates required in the provided space and note the applicable charges. Ensure the charges are correctly calculated.
5. In the ‘Information Requested’ section, specify the nature of the request by checking the appropriate box for medical reports or other documents. Complete additional fields about the period of information requested and related specialties, if applicable.
6. State the purpose of your application by marking the box that best describes your reason for the request, such as continuity of care or legal proceedings.
7. If the applicant is not the patient, fill out the ‘Details of Applicant’ section with their information, including relationship to the patient. This section must be completed for adult patients not applying on their own.
8. If the patient is aged 18 or above, they should sign the form to consent to the release of their information. If the patient is under 18 or deceased, complete the next-of-kin’s details and signature section.
9. Complete the Mode of Collection section to specify how you would like to receive the documents—either via post or in person.
10. After ensuring all information is correctly filled in, you can save your changes, download, print, or share the completed form as needed.

Start filling out the HK New Territories West Cluster Medical Report And Patient Information Application Form online today for efficient processing.