Rehabilitation Service Appointment

Patient Information
Appointment Enquiry
Other Information
Patient Information

Please leave your message here for any new appointment request or changes regarding the rehabilitation services within 30 days. In order to enhance our arrangement, please provide the required patient's information and also noted that a valid doctor's referral letter is necessary. Our centre will contact you by phone to confirm during office hour (Mon-Fri 08:00 - 20:00; Sat 08:00-17:00).

Patient Information
Appointment Enquiry
Other Information
Appointment Enquiry
Patient Information
Appointment Enquiry
Other Information
Other Information
Photos are for reference only.
* Required fields
Gender*
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
To receive a copy of the appointment enquiry, please enter an email address.
Please enter the last name
Please enter the first name
Please choose sex
Please enter age
Please enter a valid phone number
Please enter the correct email
Please enter or correct required fields
Have you used our hospital’s services before*
Yes
No
Please choose have you ever 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?
Messenger Name
Messenger Contact Information
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 or correct required fields

Preview appointment information

Patient Information
Last Name
First Name
Gender
Age
Phone +852
Email
Appointment Enquiry
Appointment Type
Have you used our hospital’s services before
Doctor Referral Letter (within 30 days)[image/pdf]
Message / Intended Appointment Date and Time
Other Information
Messaging personnel
Messenger Last Name
Messenger First Name
Messenger Phone
Messenger Email
Submit
Sending