Oncozac® - Serious Illness Patients Caring Program

When patients undergo serious illness treatments, they will commonly encounter side effects (such as loss of appetite, vomiting, etc.)

Through administration of Oncozac®, its active ingredient is proven to be effective in relieving side effects from serious illness treatment, therefore facilitate recovery of the body.

 

In order to introduce more serious illness patients to be benefit from Oncozac®, you are kindly invited to participate in this program. Successful participants will be arranged a FREE consultation hosted by the Chinese-Western medicine combination clinic, as well as a FREE Oncozac® 100 capsules.Please refer to the application details below:

  1. Serious illness patients who are diagnosed, being treated by public or private hospitals in Hong Kong
  2. Hong Kong resident

  1. Filled application form
  2. Proof of the serious illness, such as related medical appointment notes, or invoices issued by Hong Kong public or private hospitals, or specialist clinics
 

Please click “Start Application” below, and complete the required application documents and contents. After application submission, Oncozac specialists will verify your information.

Successful applicants will be informed follow-up details of the plan. If you have any questions, please contact the Oncozac specialists at 2110 0880

Please complete all fields and click "NEXT" to continue with your application. (All fields are mandatory)


Applicant's Information

Full Name:

Contact Number:

Mailing Address:

Gender:

Relationship with patients:

E-Mail:

Source of knowing this Caring Program:

District:


Patient's Information

Full Name:

ID Card initial and first 4 digits:

Serious Illness Category:

Gender:

Age:

Please provide supporting

(You can submit maximum 1 documents each time with total file size not exceeding 5MB. The supported document types include doc, docx, pdf, png, jpg, gif.)

Please provide relative follow up consultation proof/ record issued from Hong Kong Public/ Private Hospitals.


After participating Oncozac® Sponsorship Program, Oncozac® staff will follow your administration status. Before signature confirmation, please AGREE to receive follow up service and promotional materials from PuraPharm International (H.K.) Ltd, or your application will not be accepted. For more information about PuraPharm Privacy Policy Statement, please browse at http://www.purapharm.com/privacy/