Latest Documents of Health Care Voucher Scheme/醫療券計劃最新版本的表格和文件
Dear Enrolled Health Care Providers,
In administering Health Care Voucher Scheme (HCVS), it comes to our attention that outdated documents were used by some service providers when making voucher claims. Service providers are required to use the latest versions of forms and documents provided in the website of HCVS (www.hcv.gov.hk). Use of outdated version of forms and documents is not accepted. Some commonly used forms and documents can be retrieved by browsing the following web pages:
Forms for Use of Voucher
Consent of Voucher Recipient to Use Vouchers https://www.hcv.gov.hk/files/pdf/Consent_of_VR_to_use_vouchers_en.pdf
Form on Change of Particulars in eHealth (Subsidies) accounts
https://www.hcv.gov.hk/files/pdf/use_of_vouchers/Form_on_change_in_eH(S)_account_Eng.pdf
Forms in relation to share use of vouchers between spouses
Consent of Sharing Health Care Vouchers between Voucher Recipients in Spousal Relationship (Used when the spouse is unable to be present in person because of specific reason when linking up the voucher accounts)
https://www.hcv.gov.hk/files/pdf/use_of_vouchers/consent_of_sharing_HCV_en.pdf
Information Sheet for Voucher Recipients to Declare Spousal Relationship and Consent to Share Use Vouchers
https://www.hcv.gov.hk/files/pdf/enrolment_and_claiming/information_sheet_for_voucher_recipients_en.pdf
Forms in relation to enrolment matters
Application Form (For enrolling practices under new medical organisation)
https://www.hcv.gov.hk/files/pdf/application_form_en.pdf
Request to Change Particulars of Enrolled Health Care Provider (including addition/deletion of practices of existing medical organization)
https://www.hcv.gov.hk/files/pdf/DH_eHS(S)020_Request_to_Change_Particulars_EN.pdf
Authority for Payment to a Bank
https://www.hcv.gov.hk/files/pdf/Authority_To_Pay_A_Bank_Eng.pdf
We would like to remind that according to clause 51 of the HCVS Definitions, and Terms and Conditions of Agreement (the Agreement), Enrolled Health Care Providers and Associated Organizations should keep proper and full record of all “Consent of Voucher Recipient to use Vouchers” in paper form and all “Consent of Sharing Health Care Vouchers between Voucher Recipients in Spousal Relationship” until the expiry of 7 complete financial years. According to clause 5 of the Agreement, the Government may terminate the Agreement if Enrolled Health Care Providers /Associated Organizations fail to comply with any provision in the Agreement.
If there is any enquiry, please contact the staff of Health Care Voucher Division 3582 4102.
Department of Health
June 2026
已登記醫療服務提供者：
本署醫療券事務科在管理醫療券計劃(下稱「計劃」)時，注意到有部分醫療服務提供者使用舊版本的表格和文件。服務提供者必須使用在醫療券計劃網站(www.hcv.gov.hk)提供的最新版本表格和文件。填寫在舊版本的表格或文件不會被認可。你亦可點擊以下連結下載部分常用表格和文件。
與使用醫療券有關的表格
醫療券使用者使用醫療券同意書
https://www.hcv.gov.hk/files/pdf/Consent_of_VR_to_use_vouchers_tc.pdf
更改醫健通（資助）戶口個人資料表格
https://www.hcv.gov.hk/files/pdf/use_of_vouchers/Form_on_change_in_eH(S)_account_Chi.pdf
與配偶共用醫療券戶口有關的表格
擁有配偶關係的醫療券使用者共用醫療券同意書（在配偶因特定原因而無法親身到場連結醫療券戶口時使用)
https://www.hcv.gov.hk/files/pdf/use_of_vouchers/consent_of_sharing_HCV_tc.pdf
醫療券使用者聲明配偶關係及同意共用醫療券須知
https://www.hcv.gov.hk/files/pdf/enrolment_and_claiming/information_sheet_for_voucher_recipients_tc.pdf
與登記有關文件
申請表格（用於新增新的醫療機構下的執業地點）
https://www.hcv.gov.hk/files/pdf/application_form_tc.pdf
已登記醫療服務提供者更改資料表格（包括新增/刪除現有醫療機構下的執業地點）
https://www.hcv.gov.hk/files/pdf/DH_eHS(S)020_Request_to_Change_Particulars_TC.pdf
款項付予銀行授權書
https://www.hcv.gov.hk/files/pdf/Authority_To_Pay_A_Bank_Chi.pdf
謹此提醒，根據《醫療券計劃定義附表及協議的條款和條件》（下稱「協議」）第51條，已登記醫療服務提供者和其相關機構須妥善保存所有紙本《醫療券使用者使用醫療券同意書》及《擁有配偶關係的醫療券使用者共用醫療券同意書》至七個完整財政年度完結。根據協議第5條，如醫療服務提供者／相關機構未能遵守協議的任何規定，政府可以終止協議。
如有疑問，請致電3582 4102聯絡醫療事務科員聯絡。
衞生署
2026年6月
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