Chronic Disease Co-Care Scheme (“CDCC”) and Hepatitis B Co-care Scheme

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Chronic Disease Co-Care Scheme (“CDCC”) and Hepatitis B Co-care Scheme - Online Pre-register Form

If you are interested in participating, please complete the registration form below. Our staff will contact you after receiving your registration.

Please select the service below.

Chronic Disease Co-Care Scheme (“CDCC”) - Three Highs Covered (Required to select)

Hepatitis B Co-care Scheme (Required to select)

Please confirm that you fulfil the following requirements before registering for the Chronic Disease Co-Care Scheme (“CDCC”) - Three Highs Covered.

Hong Kong resident aged 45 or above (Required to select)

No known medical history of diabetes mellitus or hypertension (Required to select)

Please confirm that you fulfil the following requirements before registering for the "Hepatitis B Co-care Scheme”.

Born in or before 1988 (Required to select)

Family members (parents, siblings, offspring) or sexual partners who have chronic hepatitis B (Required)

No known medical history of chronic hepatitis B nor related symptoms (Required to select)

Surname * (Required)

Gender * (Required)

Male

Female

Contact Mobile Number * (Required) (Input 8 digits mobile number)

Can this number receive WhatsApp messages? * (Required)

Yes

No

Preferred enrolment location * (Required)

Tuen Mun District Health Centre - Core Centre (1/F, Rosedale Gardens Shopping Mall, 133 Castle Peak Road, San Hui, Tuen Mun, N.T.)

Parklane TMDHC Satellite Centre (Shop 155-156, 1/F, Tuen Mun Parklane Square, 2 Tuen Hi Road, Tuen Mun, N.T.)

Yau Oi TMDHC Satellite Centre (Shop Nos. S-201 to S-203, Zone S, Level 2, H.A.N.D.S., 2A Tuen Mun Heung Sze Wui Road, Tuen Mun, N.T.)

Shan King TMDHC Satellite Centre (Shop 4, G/F, Shan King Shopping Centre, No.1 Ming Kum Road, Tuen Mun, N.T.)

Goodrich Garden TMDHC Satellite Centre (Shop B51, 1/F, Goodrich Garden Shopping Arcade, 9 Leung Tak Street, Tuen Mun, N.T.)

Melody Garden TMDHC Satellite Centre (Shop 85, G/F, Melody Garden Commercial Complex, 2 Wu Chui Road, Tuen Mun, N.T.)

Are you a member of Tuen Mun District Health Centre? * (Required)

Yes

No

Chronic Disease Co-Care Scheme (“CDCC”) - Three Highs Covered - Referee Member No. (The referee must be a member of the Tuen Mun District Health Centre.)

Chronic Disease Co-Care Scheme (“CDCC”) - Three Highs Covered - Referee Name (Optional)

Chronic Disease Co-Care Scheme (“CDCC”) - Three Highs Covered - Referee Tel. (Optional) (Input 8 digits mobile number)

I agree that the Tuen Mun District Health Centre team may contact me regarding the referral service. I understand that the personal data provided will be disclosed to the Tuen Mun District Health Centre for the purpose of enrolling in the Scheme. * (Required)

I agree to receive electronic messages and WhatsApp messages related to TMDHC's activities and services.

* Required