Dietetic Service Appointment Message Service

Patient Information

Appointment Enquiry

Other Information

Patient Information

Please leave your message here for any new appointment request or changes regarding the dietetic service within 30 days. In order to enhance our arrangement, please provide the required patient's information and a valid doctor's referral letter / maternity booking receipt where applicable. Our hospital will contact you by phone to confirm.

Our centre service hours: Mon-Fri 09:00 - 17:30;

Sat 09:00-13:00 (last booking 12:00).

Patient Information

Appointment Enquiry

Other Information

Appointment Enquiry

Patient Information

Appointment Enquiry

Other Information

Other Information

Photos are for reference only.

* Required fields

Last Name*

First Name*

Phone +852*

After confirming the appointment date, an SMS reminder will be sent on the day before appointment. This phone number will be set as the default receiver

Email

To receive a copy of the appointment enquiry, please enter an email address.

Please enter the last name

Please enter the first name

Please enter a valid phone number

Please enter the correct email

Please enter or correct required fields

New Appointment

(Please note that a valid doctor’s referral is necessary for initial dietetic consultation)

Follow up Appointment

Change Appointment

Cancel Appointment

Service Type*

Due Date*

(Please note that a valid maternity booking receipt is necessary)

Please specify*

Intended appointment date and time

Change intended appointment date and time

Cancel intended appointment date and time

Intended Appointment Date*

Cancel Intended Appointment Date*

Intended Appointment Time*

Cancel Intended Appointment Time*

Have you used our hospital’s services before*

Yes

Yes

No

No

Upload Doctor Referral Letter/maternity receipt[image/pdf]

Please select check item

Please select due date

Please enter the check item message

Please enter booking date

Please enter cancel date

Please select booking time zone

Please select cancel time zone

Please select used the service of this hospital in the past

Please enter or correct required fields

Are you making an appointment for yourself or someone else?

For someone else

Messenger Name

Last Name*

First Name*

Messenger Contact Information

Phone +852

Email

To receive a copy of the appointment enquiry, please enter an email address.

Please enter the agent last name

Please enter the agent first name

Please enter a valid agent phone number

Please enter the correct agent email

Please enter the correct email

Please enter or correct required fields

Preview appointment information

Patient Information

Last Name

First Name

Phone +852

Email

Appointment Enquiry

Appointment Type

Service Type

Due Date

Other (Please specify)

Intended Appointment Date

Intended Appointment Time

Cancel Intended Appointment Date

Cancel Intended Appointment Time

Have you used our hospital’s services before

Doctor Referral Letter/maternity receipt[image/pdf]

Message

Other Information

Messaging personnel

Messenger Last Name

Messenger First Name

Messenger Phone

Messenger Email

Sending

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