Email hkma@hkma.org Fax 2865 0943.doc

Email hkma@ Fax 2865 0943 Change of Contact and Status Update of HKMA Member 香港醫學會會員更改聯絡方法及更新狀態 Name 姓名 Membership No. 會員編號 New Contact 新聯絡辦法 Office Tel. Fax 公司電話 傳真 Home Tel. Fax 住宅電話 傳真 Mobile Tel. Pager 手提電話 傳呼號碼 Email 電郵地址 Correspondence Address (Please delete as appropriate.) 通訊地址 (請刪除不適用的) Office公司/ Home住宅 Type of Practice: (Please tick as appropriate.) 執業範圍: (請在適當方格內填上「√」號。) □ Private私家執業 □ University大學 □ Subvented Organization政府資助機構 □ Government政府 □ Hospital Authority醫管局 □ Others其他 (Please specify請列明) I would also like to update my information on Doctors Homepage: 請更新香港醫生網的資料： □ Office Add, Tel. Fax □ Email □ Mobile Tel. Pager □ Type of Practice 公司地址、電話及傳真 電郵 手提電話及傳呼號碼 執業範圍 (For amendment of other information on Doctors Homepage, Please contact the HKMA at 2527 8285. 如欲更改香港醫生網的其他資料，請致電2527 8285 聯絡香港醫學會。) Please note the above changes effective from 以上更改之生效日期 Email Redirection Service Application Doctors’ Teahouse Password Request 申請轉發電郵服務 申請會員茶室密碼 Please assign the following address for my access to the HKMA Email Re-direct Service: Please assign the following login name and password for my access to the Doctors’ Teahouse: 我申請的醫學會轉發電郵地址為： 我申請的會員茶室登入名稱及密碼是： @ Login Name: 登入名稱： (Alphabets numeric figures only, no symbol except underscore”_” is allowed. 請填上字母或數字，不接受”_”以外的符號。) (8 to 12 characters with no space in between. 8至12個字母，中間不可留空。) Intended Destination Email Address 請把電郵轉發至： Password 密碼： (i.e. your own email address, e.g. abc@ 即你自己的電郵地址，例如abc@) (6 to 8 characters or numbers with no space in between and the first one being character only. 6至8個字母，中間不可留空，第一個字必須為字母。) Signature: Date: 簽名 日期