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[接上页] Conditions imposed pursuant to section 15(3) of the Supplementary Medical Professions Ordinance- Dated this .......... day of ................... 19 ....... Photograph .................................................... Secretary, Occupational Therapists Board. (L.N. 87 of 2004) _____________ FORM 3 [regulation 14] SUPPLEMENTARY MEDICAL PROFESSIONS ORDINANCE (Chapter 359) Occupational Therapists (Registration and Disciplinary Procedure) Regulations Particulars of a Company carrying on the Business of Practising Occupational Therapy Presented by ................................................................................................................. (Name of Company) of ......................................................................................................................................... (Registered Business Address) ............................................................................................................................................. (Business Registration Certificate No.) Particulars of the names and addresses of all persons who are professionally qualified directors, other directors or managers of the above company in respect of the business of occupational therapy carried on by it at ................................................................................... ............................................................................................................................................. under the name of ................................................................................................................. Name in full Position Cert. of Reg. No. and Date of Reg. where Directors are registered under Part I of the Register Residentia Address and of persons who practise occupational therapy in connection with the business of the said company in the above. Name in full Residential address Occupation Qualifications Cert. of Reg. No. and Date of Reg. Duties performed Dated this ........... day of .................... 19 ....... (Signature) ............................................... (State whether director or manager or secretary) _____________ FORM 4 [regulation 23(1)] SUPPLEMENTARY MEDICAL PROFESSIONS ORDINANCE (Chapter 359) OCCUPATIONAL THERAPISTS (REGISTRATION AND DISCIPLINARY PROCEDURE) REGULATIONS Notice of Inquiry [Date] Sir/Madam, On behalf of the Occupational Therapists Board notice is hereby given to you that, in consequence of a complaint made against you to the Board/information received by the Board, an inquiry is to be held into the following charge(s) against you- (If the allegation relates to conviction) That you were on the ............. day of .................... 19 ........ at ............................................................................................................................ (specify court recording the conviction) convicted of ................................................................ ......................................................... (set out particulars of the conviction in sufficient detail to identify the case). or (If the charge relates to conduct) That you ..................................................................... ............................................................................................................................................. ............................................................................................................................................. (set out briefly the facts alleged); and that in relation to the facts alleged you have been guilty of unprofessional conduct. or (If the allegation relates to obtaining registration by fraud or misrepresentation) That you ............................................................................................................................................. ............................................................................................................................................. ............................................................................................................................................. (set out briefly the facts alleged); and that in relation to the facts alleged you obtained registration by fraud or misrepresentation. or (If the allegation is that the registered occupational therapist was not qualified, at the time of his registration, to be registered) That you ........................................................................... ............................................................................................................................................. ............................................................................................................................................. ............................................................................................................................................. ................................................................................................................................. (set out briefly the facts alleged); and that in relation to the facts alleged you were not at the time of your registration qualified to be registered. |