國際醫療服務網上登記

International Patient Services Online Referral – Professionals

日期 Date: 28-01-2023 *必填Must fill
轉介醫生 Referral Doctor
病人資料 Patient Information
聯絡人 (如適用) Contact Person (if applicable)
病人病歷 General Medical Information
備註 Remarks

與醫生的診症預約前,請準備下列醫療報告(如適用):
 • 醫生記錄及/或相關住院報告(如:出院記錄、藥物及敏感資料等)
 • 與診斷相關的影像掃描報告(如:PET-CT正電子-電腦掃描, CT電腦掃描, MRI磁力共振掃描, 超聲波掃描, 乳房X光攝影, X光掃描等)及/或DICOM相容檔案
 • 病理化驗、活組織檢查或血液基因檢測報告
 • 癌症基因指標趨勢及近期化驗報告
 • 近期的整體驗血報告
 • 現正服用之藥物清單
我們將於五個工作天內回覆登記申請。

Before your appointment with our doctors, please prepare the following medical reports (if applicable):
 • Doctor's summary and/or relevant hospitalisation records (e.g. discharge summary, medications and allergy information, etc.)
 • Diagnostic reports which are relevant to your diagnosis (e.g. PET-CT, CT, MRI, ultrasound, mammogram, X-ray, etc.) and/or in DICOM compatible files
 • Pathology, Specimen tissue or blood genomic profiling reports
 • Laboratory results of tumour marker trend and recent updates
 • Laboratory results of latest overall workup
 • List of current medications
We would respond to registration application within 5 working days.

你從什麼途徑得知養和醫療集團的國際醫療服務(可選多於一項)? How did you hear about HKSH Medical Group International Patient Services (may choose more than one)? *
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,讓本集團了解你/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」。

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”.

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