The Medical Self Declaration Form is a crucial document in Hong Kong's healthcare and business landscape, designed to collect accurate health information from individuals for various purposes. This document is commonly used when organizations need to verify an individual's health status, such as during employment processes, insurance applications, school admissions, or medical facility registrations. The form must comply with Hong Kong's Personal Data (Privacy) Ordinance and relevant healthcare regulations, particularly regarding the handling of sensitive medical information. It typically includes sections for personal information, current health status, medical history, and specific health declarations relevant to its intended use. The document often requires the declarant to confirm the truthfulness of their statements, with potential legal consequences for false declarations under Hong Kong law.
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1. Personal Information: Collection of declarant's basic details including full name, ID/passport number, date of birth, gender, and contact information
2. Declaration Purpose: Statement explaining the purpose of the medical declaration and how the information will be used
3. Current Health Status: Declaration of present health conditions, ongoing treatments, and current medications
4. Medical History: Details of past medical conditions, surgeries, hospitalizations, and significant health events
5. Family Medical History: Information about hereditary conditions and significant family medical history
6. Lifestyle Factors: Information about smoking, alcohol consumption, and other relevant lifestyle factors
7. Privacy Notice: Statement explaining how personal data will be handled in compliance with the Personal Data (Privacy) Ordinance
8. Declaration and Signature: Final declaration of truth and accuracy, with date and signature
1. COVID-19 Status: Section for declaring COVID-19 vaccination status, recent exposure, and test results - include when required for current health protocols
2. Mental Health Declaration: Additional section for mental health status when required for specific purposes like employment or insurance
3. Travel Health History: Section for recent travel history and related health issues - include when form is used for travel or immigration purposes
4. Occupational Health Risks: Section for work-related health risks and exposures - include when form is used for employment purposes
5. Pregnancy Status: Section for declaring pregnancy status and related conditions - include when relevant for medical treatment or employment purposes
6. Emergency Contact: Section for emergency contact details - include when form is used in medical or institutional settings
1. Schedule A: List of Medical Conditions: Comprehensive checklist of medical conditions for reference when completing the form
2. Schedule B: Medication List Template: Template for listing current medications, dosages, and frequency
3. Schedule C: Privacy Policy: Detailed privacy policy explaining data handling procedures and rights of the declarant
4. Appendix 1: Guidance Notes: Instructions for completing the form and explanations of medical terms used
5. Appendix 2: Required Documentation: List of supporting medical documents that may need to be attached to the declaration
Relevant legal definitions
Declarant
Medical Condition
Chronic Illness
Pre-existing Condition
Prescribed Medication
Healthcare Provider
Medical Professional
Medical History
Family Medical History
Personal Data
Sensitive Personal Data
Declaration
False Declaration
Medical Treatment
Emergency Contact
Occupational Health Risk
Physical Examination
Mental Health Condition
Vaccination Status
Infectious Disease
Hospitalization
Surgical Procedure
Disability
Genetic Condition
Medical Documentation
Consent
Confidentiality
Data Processing
Medical Records
Supporting Documents
Medical Condition
Chronic Illness
Pre-existing Condition
Prescribed Medication
Healthcare Provider
Medical Professional
Medical History
Family Medical History
Personal Data
Sensitive Personal Data
Declaration
False Declaration
Medical Treatment
Emergency Contact
Occupational Health Risk
Physical Examination
Mental Health Condition
Vaccination Status
Infectious Disease
Hospitalization
Surgical Procedure
Disability
Genetic Condition
Medical Documentation
Consent
Confidentiality
Data Processing
Medical Records
Supporting Documents
Clauses
Personal Information
Medical History
Privacy and Data Protection
Consent
Declaration of Truth
Confidentiality
Information Usage
Disclosure Authorization
Medical Records Release
Legal Compliance
Liability
False Declaration Consequences
Data Storage and Processing
Third Party Disclosure
Emergency Contact Authorization
Document Verification
Rights and Obligations
Amendment Provisions
Governing Law
Signature and Acknowledgment
Medical History
Privacy and Data Protection
Consent
Declaration of Truth
Confidentiality
Information Usage
Disclosure Authorization
Medical Records Release
Legal Compliance
Liability
False Declaration Consequences
Data Storage and Processing
Third Party Disclosure
Emergency Contact Authorization
Document Verification
Rights and Obligations
Amendment Provisions
Governing Law
Signature and Acknowledgment
Relevant Industries
Healthcare
Insurance
Employment/HR
Education
Travel and Tourism
Sports and Recreation
Transportation
Aviation
Maritime
Construction
Manufacturing
Food Service
Relevant Teams
Human Resources
Occupational Health
Medical Services
Compliance
Risk Management
Employee Relations
Health and Safety
Legal
Administration
Recruitment
Insurance
Corporate Medical
Wellness
Relevant Roles
Human Resources Manager
Occupational Health Nurse
Medical Officer
Insurance Underwriter
School Administrator
Health and Safety Officer
Compliance Officer
Risk Manager
Employee Relations Manager
Healthcare Administrator
Company Doctor
Recruitment Specialist
Immigration Officer
Corporate Medical Director
Wellness Coordinator
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