Specimen Collection Kits Order Form


(This system is to be used by Hong Kong registered medical practitioners only.)

(* mandatory)

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x

Note:
  1. Subject to availability, delivery of saliva specimen bottles may be made in multiple(s) of 25.
  2. Should you have any enquiries, please call 9129 9101.

Specimen Collection Kits Order Confirmation


(This system is to be used by Hong Kong registered medical practitioners only.)

Details:

Tier:

PMP Name:

執業醫生姓名:

Clinic Name:

診所名稱:

Phone:

Delivery Address:

送貨地址:

Saliva Specimen Bottle Quantity:

Stool Specimen Bottle Quantity:

Specimen Collection Kits Order Successfully Placed


(This system is to be used by Hong Kong registered medical practitioners only.)

Your order has been successfully placed. Please record the "Code for Order Cancellation" for order cancellation purpose.

Details:

Tier:

PMP Name:

執業醫生姓名:

Clinic Name:

診所名稱:

Phone:

Delivery Address:

送貨地址:

Saliva Specimen Bottle Quantity:

Stool Specimen Bottle Quantity:

Code for Order Cancellation:

Specimen Collection Kits Order Cannot be Placed


(This system is to be used by Hong Kong registered medical practitioners only.)

Sorry, your order cannot be placed. Please make sure your previous order had been canceled.