Hong Kong Regulations

OCCUPATIONAL THERAPISTS (REGISTRATION AND DISCIPLINARY PROCEDURE) REGULATIONS - SCHEDULE 1

Register of Occupational Therapists

[regulation 3]

SUPPLEMENTARY MEDICAL PROFESSIONS ORDINANCE

(Chapter 359)

OCCUPATIONAL THERAPISTS (REGISTRATION AND DISCIPLINARY PROCEDURE) REGULATIONS

PART I

REGISTRATION NO. :
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NAME : ..................................................
................(                         )


ADDRESS : .............................................................
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BUSINESS ADDRESS :
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QUALIFICATIONS AND DATE OBTAINED :
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DETAILS OF WORKING EXPERIENCE :
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CERTIFICATE OF REGISTRATION SERIAL NO. :
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DATE OF REGISTRATION :
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REMARKS :
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Photograph

................................................... Secretary,
Occupational Therapists Board. (Enacted 1990)

PART II

REGISTRATION NO. :
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..................

NAME : ..................................................................(
) ADDRESS :
...........................................................................
..................

BUSINESS ADDRESS :
...........................................................................
..................

QUALIFICATIONS AND DATE OBTAINED :
...........................................................................
..................

...........................................................................
..................

DETAILS OF WORKING EXPERIENCE :
...........................................................................
..................

...........................................................................
..................

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..................

...........................................................................
..................

CERTIFICATE OF REGISTRATION SERIAL NO. :
...........................................................................
..................

DATE OF REGISTRATION :
...........................................................................
..................

REMARKS :
...........................................................................
..................

Photograph

.................................................... Secretary,
Occupational Therapists Board. (Enacted 1990)

PART III

REGISTRATION NO. :
...........................................................................
..................

NAME : ..................................................................(
)

ADDRESS :
...........................................................................
..................

BUSINESS ADDRESS :
...........................................................................
..................

QUALIFICATIONS AND DATE OBTAINED :
...........................................................................
..................

...........................................................................
..................

DETAILS OF WORKING EXPERIENCE :
...........................................................................
..................

...........................................................................
..................

...........................................................................
..................

...........................................................................
..................

CERTIFICATE OF REGISTRATION SERIAL NO. :
...........................................................................
..................

DATE OF REGISTRATION :
...........................................................................
..................

REMARKS :
...........................................................................
..................

...........................................................................
..................

Photograph

................................................ Secretary,
Occupational Therapists Board. (Enacted 1990)