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Supplementary Health Information Sheet for Driver Assessment(Please send to doctor for completion) () (For clients referred to \” Hospital Authority Community Rehabilitation Service Support Center\”)
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How to fill out supplementary health information sheet
How to fill out supplementary health information sheet
01
Obtain a copy of the supplementary health information sheet from your healthcare provider or insurance company.
02
Fill out your personal information, including name, date of birth, address, and contact information.
03
Provide details about your medical history, including any past surgeries, illnesses, or chronic conditions.
04
List any medications you are currently taking, including dosage and frequency.
05
Include information about any allergies you may have to medications, food, or other substances.
06
Sign and date the form to confirm that the information provided is accurate and complete.
Who needs supplementary health information sheet?
01
Individuals who are applying for health insurance
02
Patients who are seeing a new healthcare provider
03
People who are participating in clinical trials or medical research studies
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What is supplementary health information sheet?
The supplementary health information sheet is a form used to provide additional health-related details that may not be covered in the main health information sheet.
Who is required to file supplementary health information sheet?
Healthcare providers or individuals may be required to fill out the supplementary health information sheet.
How to fill out supplementary health information sheet?
The supplementary health information sheet can be filled out by providing accurate and detailed information about the specific health details requested on the form.
What is the purpose of supplementary health information sheet?
The purpose of the supplementary health information sheet is to ensure all relevant health information is recorded and accessible for healthcare providers.
What information must be reported on supplementary health information sheet?
The supplementary health information sheet may require information such as medical history, current medications, allergies, and any other relevant health conditions.
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