SEN Service - Rehabus Registration (UMSO/Hospitals Endorsed Permanent/Temporary Injuries/Disabilities for Staff)

Day Service Eligibility:
● Full-time/part-time staff with permanent disabilities/temporary injuries as endorsed by UMSO/Hospitals

● A confirmation email will be sent to you once your registration is successfully processed
● Once registered, eligible users may start booking via the Online Booking Form:
https://cloud.itsc.cuhk.edu.hk/webform/view.php?id=13671106

1. Full Name in English 1. Full Name in English First Last
2. Full Name in Chinese 2. Full Name in Chinese First Last
3. Contact Phone No.
4. Email Address (CUHK Email Address is Preferred.)
5. Staff ID
6. Employment Mode

6. Employment Mode Full-time Part-time
7. Type of Injuries/Disabilities

7. Type of Injuries/Disabilities Temporary Permanent
8. Use of Wheelchair

8. Use of Wheelchair Yes No
9. Please upload the endorsement from the University Medical Service Office (UMSO)

Attach Files
Disclaimer The personal data collected will be used by SEN Service (SENS) and authorised personnel for processing the captioned purposes in accordance with relevant provisions of the Personal Data (Privacy) Ordinance.