HK Helper Desk · Draft template · hello@hkhelperdesk.com

Employer note — medical / clinic visit

Date:

To: Clinic / hospital staff

This confirms that (helper’s full name), employed by me as a foreign domestic helper under a Hong Kong Standard Employment Contract, is attending for medical consultation / treatment on .

Employer name: _________________ Contact phone: _________________

Place of employment address: _______________________________________

Insurance / EC policy no. (if relevant to billing): ___________________

Please provide the helper with receipts and any sick-leave certificate for employment records.

Employer signature: ___________________________