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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

I chose your services because:
 我因為以下原因選擇你們的服務:
Check any that apply
HelpPlease choose all that apply 可選多項
* Overall, how would you rate the quality of care you received?
總體而言,您如何評價您所獲得的服務品質?
  1 2 3 4 5 6 7 8 9 10
Please rate from 1 (Poor) to 10 (Excellent)
請從1 (極差) 至10 (極佳) 的範圍內評分
HelpPlease choose all that apply 可選多項
* How likely are you to recommend our services to friends and family?
您向朋友或家人推薦我們服務的可能性有多大?
  1 2 3 4 5 6 7 8 9 10
Please rate from 1 (Not at all likely) to 10 (Extremely likely)
請在1 (完全不可能) 到10 (極有可能) 的範圍內評分
* For each statement, please rate your experience.
 請就以下每項陳述,評價您的體驗。
  Strongly Disagree
Strongly Disagree
非常不同意
Disagree
Disagree
不同意
Neutral
Neutral
一般
Agree
Agree
同意
Strongly Agree
Strongly Agree
非常同意
I was treated with respect and dignity.
我得到了尊重和有尊嚴的對待。
My personal needs (like comfort, privacy, or assistance) were met.
我的個人需求(如舒適度、隱私或協助)得到了滿足。
The staff listened to my views and concerns.
工作人員聆聽了我的看法和疑慮。
I was involved in decisions about my care as much as I wanted to be.
我能按自己期望的程度參與護理決策。
I was given clear information to help make decisions about my care.
我得到有助我對護理做出決定的清晰資訊。
I felt safe and well cared for.
我感到安全,也得到了很好的照顧。
My privacy was protected.
我的隱私得到了保護。
My care was well-coordinated and communicated among staff and departments.
我的護理在不同工作人員和部門之間得到了良好的協調和溝通。
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,請留下您的聯絡資料