1989 Ed.]
Venereal Disease
[CAP. 275
5
To:
FORM 2
VENEREAL DISEASE ORDINANCE
(Chapter 275)
Examination Notice
(s. 4]
According to information received in pursuance of section 3 of the Venereal Disease Ordinance (Cap. 275), I, the Deputy Director of Health have reason to believe that you may require treatment in respect of venereal disease.
I therefore, in pursuance of section 4 of the said Ordinance, give you notice that you are required to attend for, and submit to medical examination within
days of the 19, by a medical practitioner. Medical examination under this heading will be made free of charge if undergone in a government social hygiene clinic.
day of
*
FORM 3
VENEREAL DISEASE ORDINANCE (Chapter 275) Clearance Certificate
[s. 5]
To: Deputy Director of Health,
I
Department of Health.
(medical practitioner) hereby certify that I have this day examined (insert name of contact)
and I am of opinion that:
* (a) the said
*
venereal disease in a communicable form; (b) the said....
* Strike out whichever is not applicable.
is not, at the date hereof, suffering from a
does not require any further treatment.
Dated this
day of
19
,
Note:
(Signed)
Medical Practitioner
The contact may be informed by the medical practitioner of the contents of the certificate but it should not be handed to the
contact.
FORM 4
VENEREAL DISEASE ORDINANCE (Chapter 275)
Treatment Notice
[s. 5]
To:
In pursuance of section 5 of the Venereal Disease Ordinance (Cap. 275), I hereby give you notice to attend for and submit to further examination and treatment of
in accordance with direction given by
and to continue to do so, until a clearance certificate in respect of yourself has been issued.
Dated this
day of
19
"
(Signed)
Medical Practitioner
(Schedule amended L.N. 76 of 1989)