Tuen Mun Hospital Request for Medical Record Copy / Data Access... 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out Section A, 'Patient’s Particulars.' Enter the patient's name in both English and Chinese, along with their HKID/Passport number, sex, date of birth, address, and contact number. Ensure all fields are completed accurately.
3. In Section B, 'Information Requested,' select the nature of your request by checking the appropriate box. Specify the period of information requested and any relevant specialties.
4. Complete Section C if you are an applicant acting on behalf of the patient. Fill in your details including name, relationship to the patient, and contact information.
5. If applicable, have the patient sign in Section D to consent to disclose their information. If the patient is under 18 or deceased, complete Sections E and F accordingly.
6. Finally, indicate your preferred mode of release in Section G and review all entries for accuracy before submitting.

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