*表格乃掃描版本
**表格乃掃描版本並只供參考用途

TRM (HK) Limited

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**Request Form for Medical Services

Consultation Record Form
請用信紙列印

Work Injury Report Form

Approval and Referral Form

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**Medical Chit (w/HAECO logo)

Return to Work Form

Medical Report for EC

Work Injury Report Follow-up

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**Request Form for Medical Services (APEX)

Work Injury Report Form (APEX)

Approval and Referral Form (APEX)

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Work Injury Report Follow-up (APEX)

Return to Work Form (APEX)

Medical Report for EC (APEX)

​注意事項:

Request Form for Medical Services
.傳真或影印本均可接受
.醫務所服務員必須核對病人身份證上的名字跟 Form 上一樣
.必須得到主管 / 安全主任的簽署及印鑑
.病人必須於表格上簽署,以授權天一醫務所將其資料交予僱主
.清楚記錄病人的診斷結果
 
Consultation Record Form

.填寫病人的診症日期、病人姓名、診斷項目、收費及病況表格上
.病人必須於表格上簽署
.每位病人單獨使用一張表格
 
Work Injury Report

.病人須於 Report 上簽署
.醫生須於 Report 上簽署及蓋印
.將 Report 掃描及上載
 

請代保存所有文件直至工傷的 case 完結

將 Request Form 及 所有 Report 掃描到 Clinic Solution 及電郵至 tephanie@trm.com.hk, evacheung.trm@gmail.com

**For Apex:

將 Request Form 及 所有 Report 掃描到 Clinic Solution 及電郵至ada@trm.com.hk, fannyyeung.trm@gmail.com
將 Request Form 及 Work Injury Report 掃描到 Clinic Solution
將 Request Form 及 Consultation Form 交到 CSC
如有任何問題,請致電 Ms Priscilla Pang (T. 6396 0179)

收費指引:

病人不需繳付任何費用,請記帳 TRM (HK) Ltd

會計程序:

.請將所有文件一併交回會計部。會計部請將發票郵寄至以下地址︰
 
 Attn: Ms Priscilla Pang

 

    1/F, Tak Lee Commercial Building

    113-117 Wanchai Road

     Wanchai, Hong Kong


    電話︰6396 0179
 email: priscillapang.trm@gmail.com