Request an appointment 預約要求

預約要求
Request an appointment
日期 Date:19-03-2024
病人資料 Patient Information
備註 Remarks
收集個人資料聲明 Personal Information Collection Statement

就你/病人提供有關資料並與養和醫療集團(下稱「本集團」)及其成員(包括∶養和醫院、各養和醫健醫療中心及任何日後養和醫療服務提供者)的溝通,讓本集團瞭解你/病人的需要,並讓本集團考慮你/病人是否適合接受本集團的醫療服務。你/病人明白在醫生作出醫療診症前有關各方溝通過程中的任何意見、陳述或建議,並不構成任何醫療意見。 若你/病人需要任何緊急醫療諮詢或治療,請諮詢你/病人的醫生。

By providing your information to and engaging in communication with HKSH Medical Group (“Group”) and members of the Group, including Hong Kong Sanatorium & Hospital, HKSH Healthcare and any future healthcare services providers of the Group, you would allow us to understand your needs and consider your suitability for receiving medical services at the Group. You understand that any opinion, statement or advice expressed during the course of communication before medical consultation with doctors does not constitute any medical advice. If you require any immediate medical advice or treatment, please consult your doctor.

聲明 Declaration

本人/病人聲明所提供的資料為正確、準確及完整。本人/病人謹此聲明已閱讀、明白和同意以上備註所列出的條款及「收集個人資料聲明」。

由於「2019冠狀病毒病」的情況,本人/病人同意遵守本集團所實施的防疫措施,如果本人/病人不遵守這些措施,本人/病人將被拒絕進入。詳情請參閱"緊急應變級別"。

By submitting, I / Patient declare that the information provided in this form is correct, accurate and complete. I / Patient declare that I / Patient have read, understood and agreed with the terms listed on the above remarks and the “Personal Information Collection Statement”.

Due to COVID-19, I / Patient agree to follow the precautionary measures implemented by the Group and I /Patient will be refused entry if I / Patient do not comply with these measures. For details, please refer to“Emergency Response Level”.

本人確認已細閱「收集個人資料聲明」"緊急應變級別",並同意相關條款。
I confirm that I have read and hereby agreed to the terms of the “Personal Information Collection Statement” and "Emergency Response Level"..

此預約尚待確認,請留意提交表格後,養和將會盡快以電話或電郵為您確認預約。
This is not a confirmed booking. Please note that after the submission of this e-form, we will confirm your appointment by phone or email in due course.

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