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Survey 問卷

How well were you cared for?
您對我們醫護服務的意見

 

We aim to provide the highest standard of care. To help us make continuous improvements, please complete this survey and return it to our staff at your convenience.

There is space at the end for any further comments.

我們致力提供優質的醫護服務。煩請填寫問卷,給予我們寶貴的意見,讓我們持續提升服務質素。填妥後,請把問卷交予工作人員。

下面另有空位可供填寫其他意見。



Admission Date 入院日期

* TYPE OF SERVICE 使用的服務類型
HelpPlease choose one of the above 請選上列其中
Room Number 房間號碼

* It is important to us that you received the best possible care, please help us improve by completing this survey.
 我們非常重視你是否得到最好的護理,請填妥以下問卷幫助我們改善。

  Excellent
Excellent
優秀
Good
Above Expectation
優於預期
Fair
Fair
一般
Below Expectation
Below Expectation
遜於預期
Poor
Poor
差劣
Did you feel well cared for?
您有否覺得獲得良好的照顧?
Did we listen and involve you in your care?
我們有否聆聽並回應您的需要?
Did we treat you respectfully as an individual?
您有否覺得被尊重?
Did you feel you had adequate information to make decisions about your treatment and care?
在治療及護理過程中,您有否獲得足夠的資訊去作出決定?
Did we ensure you had privacy?
我們對您的私隱有否提供充足的保障?
I chose your services because:
 我因為以下原因選擇你們的服務:

HelpPlease choose all that apply 可選多項
We invite you to share further comments on what we did well :
請分享我們值得稱許的地方

We invite you to share further comments on how we could do even better (if your comments involve facilities improvement in your room, please leave your room number) :
請分享我們可以改善的地方 (如的意見包含改善房間內的設施,請提供的房號)

If you would like us to contact you about your experience please leave your contact details:
如果希望我們跟聯絡,請留下你的聯絡資料