Swire Hong Kong Staff Association(For Swire Group Staff) - Preferential Dental Plan Application / Renewal Form I would like to participate in the Dental Plan at my own cost and agree to be abide by the following terms and conditions : - (1) Validity of the Plan Year : 12 Calendar months from the month of commencement. The Plan will commence on the first day of the following month after cheque payment is cleared. Members may re-new the Dental Plan one month before the expiry date. (2) Plan Cover : (Please select Plan A or Plan B ) This Form Effective from 1st April,2018. Plan A : HK300 per head per annum Plan B : HK380 per head per annum A1. Free consultation and annual dental examination B1. Free consultation and bi-annual dental examination A2. Annual scaling and polishing B2. Bi-annual scaling and polishing A3. Annual fluoride treatment to all teeth to prevent decay B3. Bi-annual fluoride treatment to all teeth to prevent decay - once a year - twice a year A4. Unlimited intra - oral digital x-ray when required B4. Unlimited intra - oral digital x-ray when required A5. Unlimited visit of emergency dental consultation B5. Unlimited visit of emergency dental consultation within normal office hour, including : within normal office hour, including : i. oral incision and drainage of dental abscess i. oral incision and drainage of dental abscess ii. control of haemorrhage ii. control of haemorrhage iii. dressings for relief of acute toothache iii. dressings for relief of acute toothache A6. Unlimited temporary / intermediate filling B6. Unlimited temporary / intermediate filling A7. Unlimited simple extraction of decay tooth by B7. Unlimited simple extraction of decay tooth by local anaesthetics non - surgical local anaesthetics non - surgical A8. Unlimited fillings of decay tooth either ( silver for posterior ) B8. Unlimited fillings of decay tooth either ( silver for posterior ) or ( composite for anterior ), except wisdom tooth or ( composite for anterior ), except wisdom tooth A9. Unlimited dental medication if required B9. Unlimited dental medication if required (2.1) General Exclusions of Plan A and B : 1. Consultation and treatment by specialists 2. The extraction of wisdom teeth or impacted teeth surgery 3. Cosmetic dentistry, orthodontics x-rays and extractions 4. Crowns, bridges, dentures and implants 5. All kinds of Root Canal Therapy and Periodontal Therapy 6. Abrasion, erosion, attrition and fractures 7. Any other items not covered in Plan A or Plan B as mentioned above. (2.2) Special discount will be offered for all other dental treatments not covered by the Dental Plan. (3) PAYMENT TERMS : The premium will be paid by (1) crossed cheque in favour of " Dr. Steven Chung Dental Surgery Ltd." and (2) this Application Form and a (3) staff card copy, directly post to 12/F., Metropole Building, 63 Peking Road, Tsimshatsui, Kowloon on or before 20th of the month. The Dental Plan will commence at the first day of the following month after cheque payment is cleared. Plan Membership is valid until expiry of the relevant Plan Year. There is no refund of premium paid. Plan membership is not transferable. (4) APPOINTMENTS FOR TREATMENT : Appointment should be made with the designated clinic by phone in advance for regular treatment. Notice should be given for cancellation of appointments. (4.1) The HKID Card should be presented at the time of consultation. ~SHKSA - Apr,18 - S1+ / S2+ (4.2) A " Patient Card " will be issued and should be presented at the time of each subsequent consultations. Part A. Employee's Particulars : ( please fill in both Parts) * Enquiry Hotline : 2368 8131 Employing Company : Staff Name Correspondence Address : Part B. Applicants Particulars ( including participating employee) Staff No. Contact No. Name of Applicants HKID No. D.O.B. (DD/MM/YY) Gender Relationship Contact No. Plan A or B Plan A : 300 x Head = HK / / Self A / B Plan B : 380 x Head = HK Employee's Signature : Total Premium : Cheque No. : Date : Disclaimer by Swire Hong Kong Staff Association ("SHKSA"): SHKSA is responsible for distributing this offer only. We do not assume any legal or financial liability for any disputes over such transactions. SHKSA members and staff of the Swire group are advised to check and confirm all relevant information before placing any order.
For internal information only, NOT for public circulation. 職員內部資料 查詢熱線 Enquiry Hotline : 2368 8131 鍾慶銓牙科醫生醫務所 - 地址及診症時間 : Dr. Steven Chung Dental Surgery - Clinic addresses & Opening Hours: 診症時間 Opening Hours: 星期一至星期五 9:00 a.m. - 1:00 p.m. 星期六 9:00 a.m. - 1:00 p.m. Mon - Fri 2:30 p.m. - 6:30 p.m. Sat 2:00 p.m. - 5:00 p.m. (1) Tel : 2869 8198 香港中環夏愨道 10 號和記大廈商場 1 樓 112C 室 ( 中環港鐵站 " J3 " 出口, 香港會所側 ) Suite 112 C, 1/F, Hutchison House, Shopping Mall, 10 Harcourt Road, Central, Hong Kong. (Central MTR Exit J3) (2) Tel : 2312 0798 香港鰂魚涌英皇道 979 號德宏大廈 6 樓 601 室 ( 鰂魚涌港鐵鐵站 A 出口 ) Room 601, 6/F, Devon House, Taikoo Place, 979 King's Road, Quarry Bay, Hong Kong. ( Quarry Bay MTR Exit A ) 診症時間 Opening Hours: 星期一至星期五 9:00 a.m. - 1:00 p.m. 星期六 9:00 a.m. - 1:00 p.m. Mon - Fri 2:30 p.m. - 7:00 p.m. Sat 2:00 p.m. - 5:00 p.m. (3) Tel : 2368 8008 九龍尖沙咀北京道 53-63 號國都大廈 12 樓 ( 尖沙咀港鐵站 " E " 出口 ) 12/F, Metropole Building, 53-63 Peking Road, Tsimshatsui, Kowloon. ( TST MTR Exit E, opposite I-square ) (4) Tel : 2757 3818 九龍灣德福花園 I 座地下 P1B 室 ( 九龍灣港鐵站 B 出口 ) Unit P1B, G/F., Block I, Telford Gardens, Kowloon Bay, Kowloon. ( MTR Exit B )
Dr. Steven Chung Dental Surgery - Dentist and Hygienist List : Director 1. Dr. David Lau D.M.D. (PENN. U.S.A.) University of Pennsylvania Doctor of Dental Medicine Specialist 2. Dr. Teresa Ng Orthodontist B.D.S.(HK), M orth(hk), M Orth RCS(Edin), Adv Dip Orth (HK), FCDSHK (Orthodontics), FHKAM (Dental Surgery) 3. Dr. Ivan Tsui Oral Surgeon B.D.S. (HK), MDS (Oral & Maxillofacial Surgery) (HK), MOS RCSEd, FRACDS, FHKAM (Dental Surgery), FCDSHK(Oral & Maxillofacial Surgery) 4. Dr. Chong Mei-Man Oral Surgeon BSc (Bristish Columbia), B.D.S. (HK), MDS (Oral & Maxillofacial Surgery) (HK), MOMS RCSEd, AdvDipMOS(HK), FHKAM(Dental Surgery) FCDSHK(Oral & Maxillofacial Surgery) 5. Dr. Gordon Chung Specialist in Periodontology 6. Dr. Elvis Tsang Specialist in Periodontology Associate Dentist 7. Dr. Cora Ko Root Canal Dentist B.D.S.(HK), MDS (Periodontology)(HK), Adv dip Periodont(HK), MRD RCSEd(Perio), FHKAM (Dental Surgery), FCDSHK(Perio) B.D.S.(HK), MDS (Periodontology)(HK), Adv dip Periodont(HK), MRD RCSEd(Perio), FHKAM (Dental Surgery), FCDSHK(Perio) BDSc, MDS (Endo) (HK), Adv Dip Endodont (HK), MRACDS(Endo) 8. Dr. Chan Yung Dick B.D.S. (HK), MFDS RCSEd, MFDS RCPS (Glasg) 9. Dr. Rita Chan B.D.S. (HK), FRACDS 10. Dr. Alexander Lee B.D.S. (HK) 11. Dr. Jessica Choi B.D.S. (HK) For internal information only, not for public circulation.
Dental Hygienist 12 Jenny Wong Hygienist E.D.H. (H.K.) 13 Jessie Chau Hygienist E.D.H. (H.K.) 14. Alice Chu Hygienist E.D.H. (H.K.) 15. Vincy Chu Hygienist E.D.H. (H.K.) 16. Lynna Wong Hygienist E.D.H. (H.K.) According to the Professional Code and Conduct issued by the Dental Council, dentists are prohibited from any form of advertisement or canvassing. As such, no dentist information will be published or printed on any promotional materials. For internal information only, not for public circulation.
Special Rate given to Plan Members for the treatments not covered by the Dental plan :- ( Only For Internal Reference, NOT for Public Circulation ) ~ SHKSA - Apr,2018 Items 治療項目 ^ Original Price 原價 # Discounted Price 優惠價 ^ Specialist 專科醫生優惠價 Further Scaling and Polishing 後加洗除牙石 800 400 Panoramic X-ray 口腔全景數碼 X 光 800 300 Study Model 檢驗牙模 1,200 800 Composite Filling 瓷粉補牙 - Abrasion - 刷蝕耗損 800 350 - Diastema - 牙縫空隙 1,800 - Non-Covered Molar and Pre-Molar Composite Filling ( 1 surface ) - 不包括 ( 大 小臼齒 ) 普通蛀牙白瓷粉 ( 一面牙面 ) 800 400 - Non-Covered Molar and Pre-Molar Composite Filling ( 2 surfaces ) - ( 二面牙面 ) 600 - Non-Covered Molar and Pre-Molar Composite Filling ( 3 surfaces ) - ( 三面牙面 ) 1,800 900 Fissure sealant (each tooth ) 牙紋防蛀劑 ( 每一隻牙 ) 800 350 Pulp treatment for children 乳齒牙髓治療 2,000 1,200 Root Canal Treatment (By X-ray) (2D) : - incisor ( single canel) 普通 X 光根管治療 : - 門牙 ( 單根管 ) 3,000 2,500 - incisor ( two canels) - 門牙 ( 雙根管 ) 4,000 3,000 - premolar ( single canal ) - 小臼齒 ( 單根管 ) 4,000 3,000 - premolar ( two canals) - 小臼齒 ( 雙根管 ) 4,500 - molar - 大臼齒 4,500 - molar ( four canals) - 大臼齒 ( 四條根管 ) 5,500 4,500 Microscopic Root Canal Treatment : - incisor (new case) 顯微鏡手術根管治療 : - 門牙 8,000 6,800 (3D) - premolar (new case) - 小臼齒 9,000 7,600 - molar (new case) - 大臼齒 10,000 8,600 - incisor **(failure case, re-treat) - 門牙 ** 11,000 9,000 - premolar**(failure case, re-treat) - 小臼齒 ** 12,000 10,000 - molar**(failure case, re-treat) - 大臼齒 ** 14,000 11,000 Specialist Consultation Fee 專科醫生檢查費 1,200 800 Galileo 3D Digital CT Scan ( @ Jaw) 德國嘉俐略 3D 數碼電腦掃描 ( 上顎或下顎 ) 1,200 Implant - Nobel ( each tooth) 植牙 ( 每一隻牙 ) 35,000 28000+ Orthodontic (Metal Braces) 矯齒 60000+ 43000+ Para Post 現成牙樁 1,000 800 Fiber Post 透明牙樁 2,000 Cast-Post 倒模牙樁 2,000 Pin 牙釘 300 200 Remove old crown ( each) 拆除舊牙套 ( 每一隻 ) 800 500 Crown & Bridge - Anterior (@ unit ) 牙冠及牙橋百合金內殼 - 前面門牙 ( 每一隻牙 ) 5,000 - Posterior (@ unit ) - 後面大小臼齒 ( 每一隻牙 ) 4,200 3,000 Denture : Plastic 活動牙托 : 膠托 4,000 2,800 Chrome 鋼托 5,000 (each tooth) ( 每一隻牙 ) 300 200 Page 1 out of2
Special Rate given to Plan Members for the treatments not covered by the Dental plan :- ( Only For Internal Reference, NOT for Public Circulation ) Extraction Items 治療項目 ^ Original Price 原價 # Discounted Price 優惠價 ^ Specialist 專科醫生優惠價 脫牙 Fractured roots / Complicated extraction 碎裂牙腳 / 複雜脫牙 2,000 Upper wisdom extraction without surgery 非手術式脫上智慧齒 2,000 Lower wisdom extraction without surgery 非手術式脫下智慧齒 3,000 2,500 Wisom tooth Impaction Surgical : 手術脫阻生智慧齒 - partial erupted : vertical single - 部份長出 : 直出阻生單牙根 4,000 : mesio angular single : 向前傾斜阻生單牙根 4,500 3,800 : mesio angular horizontal/vertical/muti-rooted : 向前傾斜水平橫向阻生 / 叢生牙根 ( 兩條以上 ) 5,000 4,000 : horizontal/vertical/dilacerated, severe curvature, multi-roots : 水平橫向阻生傾斜智慧齒 6,000 - fully embedded : vertical - 完全隱蔽 : 直出阻生單牙根智慧齒 8,000 : mesio angular : 向前傾斜阻生智慧齒 8,000 : horizontal : 水平橫向阻生智慧齒 10,000 8,500 : ectopic / multi-rooted : 叢生牙根智慧齒 12,000 10,000 - impacted canine / pre-molar 阻生犬齒 / 小臼齒 16,000 14,000 Apico Surgery 割除牙根尖手術 8,000 Orthodontic Retainer (each) 矯齒固定器 ( 每一個 ) - acrylic 硬咬合膠 5,000 4,000 Soft bite plane 軟咬合膠 2,000 1,200 Silensor 助眠器 9,000 Teeth Bleaching ( Home Bleaching) 家居専業漂牙 6,000 Professional Laser Teeth Whitening 專業激光美白牙齒 10,000 8,000 Crown and Bridge ( each unit ) 牙冠及牙橋 ( 每一隻牙 ) Crown on gold ( each unit ) 黃金內殼牙冠 ( 每一隻 ) 10,000 9,000 Empress / Procera ( each unit ) 全瓷燒瓷牙冠 ( 每一隻 ) 10,000 6,800 Composite Veener ( each unit ) 樹膠質牙片 ( 每一隻 ) 3,000 2,000 Porcelain Veener ( each unit ) 高溫全瓷貼 ( 每一隻 ) 10,000 6,800 ^ The original prices and Specialist price list are for reference only, and may change withour prior notice. ^ 原價收費及專科醫生優惠價只供參考之用, 如有更改, 恕不另行通知 ** 曾經在別處醫生治療失敗, 由本醫務所資深醫生重做之收費 ~ SHKSA - Apr,2018 Page 2 out of2