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Application for Patient Data

Notes of Application for Medical Report / Patient's Information

  1. Consent of patient / patient's legal guardian should be obtained for an applicant to apply for the patient's medical report / patient's information.
  2. Consent of patient's parent / guardian should be obtained for an applicant to apply for the medical report / patient's information if the patient is under 18 years of age.
  3. Consent of patient's personal representative should be obtained for an applicant to apply for the medical report / patient's information if the patient is a deceased.
  4. All relevant supporting documents of the applicant, patient, and concerned parties should be presented for verification of identity upon request. Copy of the documents may be required if necessary. Examples of the supporting documents are:
    • Marriage Certificate
    • Hong Kong Identity Card
    • Birth Certificate or Legal Custody Paper (if the patient is under 18)
    • Probate or Letter of Administration (if the patient is deceased)
  5. The specialty responsible for completion of medical report / patient's information and all relevant information about the attendance of the patient, including dates, receipts and follow-up card must be specified upon submission of request.
  6. If the reason for request is "Claim for Compensation / Insurance", please attach the relevant insurance form. Doctor will complete the medical report either in essay form or in the provided form.
  7. An authorized signature of the patient is required if there is any amendment made on the documents / application form.
  8. According to the policy of Hospital Authority, $895 should be levied for each specialty of medical report. A maximum of $3,580 will be charged per hospitalization. $230 will be charged for general requests (Proof of Date of Death, Date of Admission & Discharge, Birth Date & Time, Attendance Record, copy of Medical Certificate). Regarding the charges for other special requests, please contact our staff.
  9. Charges for all requests should be paid during submission. The minimum charge of HK$895 should be paid when submitting an application for medical report. Payment by cheque should be crossed and made payable to the 'Hospital Authority'.
  10. Under no circumstances will the application for medical report / patient's information be processed without receiving consent from patient or patient's authorized person, checking original and copy of relevant documents and paying the charges.
  11. No refund of the charge for medical report / patient's information will be made once an application is made.
  12. All medical reports / patient's information are written in English. The information provided will be until the date of application or subject to the doctorˇ¦s decision on the relevancy of the case.
  13. Each medical report / patient's information will be completed in around eight weeks. For any amendment request, please submit the original copy of medical report / patient's information. Please note that such amendment is subject to our doctors / hospital management's final decision.
  14. All medical report / patient's information will be sent to the applicant by "Registered Post" unless specified upon application.
  15. If you have any queries, please contact us at
    Enquiry Number:    (852) 2636 7288 / 2636 7208
    Facsimile Number: (852) 2635 1492
    Address:                 General Office, G/F, Cheshire Home, Shatin,
                                  30 A Kung Kok Shan Road, Shatin, N. T.
    Office Hour:           Monday to Friday, 8:45am - 5:30pm
                                  Saturday, Sunday and Public Holiday: Closed

Remark: "Original consent" or "certified true copy" of the consent is required for application of medical report / patient's information.

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