Named Patient Program Hong Kong

Medications or drug do not formally registered in Hong Kong is required for named patient use. The physicians should inform the concerned patients on the use of unregistered products and that adverse effects of name patient drug use would be monitored and reported. The concerned supplier of the unregistered drugs should provide in name patient basis, together with the application for importation, a certificate of analysis, in the absence of which the requesting clinician is required to sign an additional declaration to take up responsibility for use of the unregistered drugs.

Logistics

Fill in the name patient program information form as below.
Consultation with our Selected Specialists to confirm the needs and the possible adverse experience of the medications.
Consultation Fee and Medication fee should be paid by Patient to doctor directly.
All medications should be prescribed and taken in the respective clinic, import / export to other countries are not allowed.
Service Fee: HK$ 5800, pay before consultation with Specialists.

Name Patient Program Information Form

Drug Name:

Drug Manufacturer Company Name:

Do you have the Referral Letters from your physicians:

Yes No

Contact (At least one):
Whatsapp / Wechat / Phone / Email

I agree for my data provided in this form to be transferred to Our Customer database, for upcoming communications e.g. Newsletters, etc.

Yes No