Appointment Form

Please kindly fill in your particulars.

* Name is necessary

Mr Mrs Miss

For comfirmation purpose, please fill in your phone number and E-mail.

* Contact number is necessary

* Email is necessary

Old Patient New Patient

Note:If none is specified,staff will allocate accordingly.
Please kindly tick the required service:

General Practitioner Specialist

Standard Executive Priemier

PuXi Clinic PuDong Clinic

Thank you for choosing GHC as your healthcare provider.
Please kindly download and fill up the patient contact form attached.