Specimen Collection Kits Order Cancellation Form


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

(* mandatory)

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Order Date:

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 Cancelled


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

Your order has been successfully cancelled.

Specimen Collection Kits Order Cannot be Cancelled


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

Sorry, your order cannot be cancelled.