List of Hosoitals that Keep Copies of the Application Form for Reimbursement I Direct Payment of Medical Expenses (Except Cancer Drugs Provided by the Authority) and Application Form for Direct Payment of Medical Expenses on Cancer Drugs Provided by the

Responsible Office I Location I Cluster Hospital Telephone Office Hours Pamela Youde Main Block Enquiry Counter I 2595 6205 East Cluster Nethersole G/F., Main Block, Pamela Youde Nethersole Eastern Eastern Hospital Hospital I Monday to Friday 9:00a.m. to 5:00p.m. Saturday 9:00 a.m. to 1 :00 p.m. Ruttonjee Medical Records Office I 2291 1035 Hospital LG1, Hospital Main Building, I Monday to Friday 9:00 a.m. to 1 :00 p.m. 2:00p.m. to 5:30p.m. Saturday 9:00 a.m. to 12:00 noon St. John Hospital Personnel Office I 2981 9442 2/F., Out-Patients Block, St. John Hospital I Monday to Friday 9:00 a.m. to 1 :00 p.m. 2:00p.m. to 5:00p.m. Hong Kong Queen Mary Health Information & Records Office I 2855 4175 West Cluster Hospital 2/F., Block S, Queen Mary Hospital I Monday to Friday 9:00 a.m. to 1 :00 p.m. 2:00p.m. to 5:00p.m. Saturday 9:00a.m. to 1:00 p.m. Grantham Patient Relations Officer I 2518 2182 Hospital 1/F., Kwok Tak Seng Heart Centre, I Monday to Friday 9:00 a.m. to 5:00p.m. -2-

Responsible Office I Location I Cluster Hospital Telephone Office Hours Kwong Wah Medical Report Office I 3517 5216 West Cluster Hospital 3B, Administration Building, I Monday to Friday 9:00 am. to 1:00 p.m. 2:00p.m. to 5:00p.m. Saturday 9:00 a.m. to 1 :00 p.m. Closed for Public Holidays Caritas Medical Medical Report Section I Medical Record Office 3408 7992 Centre 13/F., Wai Oi Block, I Monday to Friday 8:30 a.m. to 1:00 p.m. 2:00p.m. to 5:15p.m. Princess Margaret Medical Records Office I 2990 1733 Hospital 3/F., Block G, Princess Margaret Hospital I Monday to Friday 8:45a.m. to 1:00 p.m. 2:00p.m. to 5:30p.m. Data Access Request/Medical Report Office I 2417 8146 Room 329, 3/F., Block B, Yan Chai Hospital I Monday to Friday 8:30 a.m. to 1 :00 p.m. 2:00p.m. to 5:30p.m. Kowloon Queen Elizabeth Medical Information Registry Office I 2958 8435 Central Hospital Room 12, 1/F., Block E, Queen Elizabeth Hospital I Cluster Monday to Friday 9:00 a.m. to 1:00 p.m. 2:00p.m. to 5:45 p.m. Hong Kong Eye Medical Records Department I 2762 3013 Hospital G/F., I Monday to Friday 8:30a.m. to 1:00 p.m. 2:00p.m. to 5:30p.m. Kowloon East United Christian Medical Report Office I 3513 4070 Cluster Hospital G/F., Block H, United Christian Hospital I Monday to Friday 9:00 a.m. to 1:00 p.m. 2:00 p.m. to 5:00p.m. Saturday 9:00 a.m. to 1:00 p.m. Tseung Kwan 0 Admission Office I 2208 0346 Hospital G/F., Tseung K wan 0 Hospital I Monday to Friday 8:00 a.m. to 4:00 p.m. Saturday 8:00 a.m. to 12:00 noon - 3-

Responsible Office I Location I Cluster Hospital Telephone Office Hours New Prince of Wales Medical Records Office I 2632 2416 Territories Hospital 2/F., Main Block, Prince of Wales Hospital I East Cluster Monday to Friday 9:00 a.m. to 1:00 p.m. 2:00p.m. to 5:30p.m. AliceHo Miu Admission Office I 2689 2041 Ling Nethersole Block A, G/F., Alice Ho Miu Ling Nethersole Hospital Hospital I Monday to Friday 8:00 a.m. to 12:00 noon 1:00 p.m. to 4:00 p.m. North District Health Information & Record Department I 2683 7042 Hospital Lower Ground Floor, I Monday to Friday 8:45 a.m. to 1:00 p.m. 2:00p.m. to 5:30p.m. New TuenMun Health Information & Record Office (Release of 2468 5371 Territories Hospital Health Information) I West Cluster 3/F., Rehabilitation Block, I Monday to Friday 9:00 a.m. to 1 :00 p.m. 2:00p.m. to 5:00p.m. Saturday 9:00 a.m. to 1 :00 p.m. Health Information & Records Department 2486 8538 MIF, Pok Oi Hospital Monday to Friday 9:00 a.m. to 1 :00 p.m. 2:00p.m. to 5:00p.m. Saturday 9:00 a.m. to 12:30 p.m.

Note 1. Eligible persons are advised, having regard to their own circumstances, to bring along the application form as far as possible when they attend medical consultation at HA facilities. They may obtain a copy of the application form from the departmental secretaries or the Pensioner Services Unit of Civil Service Bureau (in the case of retired officers), or download the form from the CSB website at www.csb.gov.hk.

2. In case eligible persons have not brought along the application form, they may approach the abovementioned offices during office hours to ask for a copy of the form.