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Enquiry

Enquiry (查詢)

Make an appointment 預約 / General enquiry 一般查詢 / External referral 外部轉介
(This question is mandatory)

Personal Information Collection Statement

  1. The information collected in this form will be used for the application and liaison in the activities of the School of Optometry, The Hong Kong Polytechnic University. All such information will be destroyed after use.
  2. If you need to check or change your personal information after submitting this form, please contact the Optometry Clinic via email: optclinic.enquiry@polyu.edu.hk
  3. The personal data collected in this form can be owned, transferred and used for audit, liaison, administration and planning purposes by the School of Optometry, The Hong Kong Polytechnic University.

 

收集個人資料聲明

  1. 此表格所收集的資料將用作處理參與香港理工大學眼科視光學院活動的申請及聯絡之用，此等資料將於無需保留時全部銷毀。
  1. 如在遞交此表格後要查閱或更改個人資料，請透過電郵致optclinic.enquiry@polyu.edu.hk 聯絡眼科視光學診所。
  1. 此表格所收集的個人資料，均可由香港理工大學眼科視光學院持有、轉告及用於審核、聯絡、行政及策劃之用途。
Patient information 應診者資料
(This question is mandatory)

Name 姓名 / Patient Name 應診者姓名

(Must be identical to the information on HKID card or Passport 必須與身份證或護照資料相同)

Date of Birth 出生日期
Open date/time selector
Contact person 聯絡人
(This question is mandatory)

Contact no. 聯絡電話

Email Address 電郵地址

Nature of Enquiry 查詢種類
(This question is mandatory)
Make an appointment 預約
(This question is mandatory)

Welcome for making appointment. 歡迎閣下預約

You may also book the primary eye examination  through the web booking system: https://ocwb.polyu.edu.hk/

閣下亦可透過網上預約系統https://ocwb.polyu.edu.hk/預約綜合眼科視光檢查

Please see the below before making appointment. 預約前請留意以下細則

The service user should understand that the PolyU Optometry Clinic is a teaching clinic and agree that his/her clinical data can be used for teaching and research purposes.

Eyedrops for dilating pupils may be used during the examination. After dilation, your eyes will become sensitive to light and your near vision may be blurred for approximately 4-6 hours. Please bring a pair of sunglasses or an umbrella to use to minimize discomfort. You may purchase a glare filter at our reception counter if necessary. Do not operate machinery, drive a car, ride a motorcycle or bicycle. Under normal circumstances, the pupils will return to normal after 4-6 hours.

應診者須明白香港理工大學眼科視光學診所是一間教學診所，並同意其臨床紀錄可用作教學及科研用途。

檢查過程中可能會使用放瞳的眼藥水。放瞳後大約4-6個小時﹐眼睛會對光線敏感及影響看近距離的視力。因此﹐我們建議應診者可擕帶太陽眼鏡或雨傘﹐減低陽光對眼睛造成的不適。如有需要﹐應診者亦可向客戶服務主任購買遮光鏡片。此外﹐請暫時避免操作機器、駕駛車輛、摩托車或自行車。一般情況下﹐瞳孔會於4-6小時內回復正常。

Kindly note that the primary eye care consultation fee under the registered optometrist is $680 (age at 5 or above) or $800 (age below 5) and the consultation fee under the student optometrist is $300.

Appointment on weekdays from 9am to 6pm. Saturday 9pm to 5pm.

本診所的眼睛檢查服務由實習視光師及註冊視光師提供予公眾人士。由實習視光師提供的綜合眼科視光檢查費用為300元正; 而由註冊視光師提供的檢查費用為680元正 (5歲或以上)或800元正 (5歲以下)。

診症時間為星期一至星期五上午九時至下午六時。星期六上午九時至下午五時。

Type of Service 服務種類
(This question is mandatory)
Patient
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External referral 外部轉介

Please upload the referral letter

請上載轉介信

 

 Upload file
Reschedule appointment 更改預約
(This question is mandatory)

Original appointment on:

原有預約:

 

Open date/time selector
Dispensing product 眼鏡及相關產品
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Please upload photos or documents 請上載相片或文件 (Optional)
 Upload file
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Please enter the message 請輸入訊息
General enquiry 一般查詢
(This question is mandatory)

Please enter the message  請輸入訊息

 
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