健康講座服務意見調查表格
Health Talk Service Survey Form

( 主辦機構填寫 To be completed by the organiser )

 
多謝 閣下選用我們的健康講座服務。請填妥以下表格,您的寶貴意見和建議,定能提升我們的服務質素。
Thank you for choosing our health talk service. Your comments and suggestions are essential for our continuous improvement. Please complete the form below.

*必須填寫Mandatory Fields

 

1. 健康講座基本資料 Details of the Health Talk
 
講座名稱 *
Title of the Talk
必須填寫Mandatory Fields.
講者姓名
Name of the Speaker
講座日期*
Date of the Talk
必須填寫Mandatory Fields.
報名人數*
No. of Enrolled Participants

必須填寫Mandatory Fields.請填入人數
出席人數*
No. of Attendance
必須填寫Mandatory Fields.請填入人數
邀請本機構安排是次講座之原因
Reason for arranging this health talk

2. 您從什麼途徑知道本中心的服務? How did you get to know our service?
可選擇多項 You may select multiple answers
親友介紹 Referral from Friends /Relatives 機構網頁 Organisation Website
其他機構介紹 Referral from Other Organisation 機構 Facebook專頁 Facebook Page
本中心職員介紹 Referral from Centre Staff 網上搜尋 Internet
宣傳單張/刊物 Promotion Material 橫額廣告 Banner
報章/電視/電台 Newspaper, Television or Radio 小巴/巴士/港鐵廣告 Transport Advertising
機構通訊「社康之聲」Agency Newsletter 'Voice of The Community Health' 其他途徑 Other Channels

3. 貴機構於過往曾使用本機構健康講座多少次?How many times have you used our Health Talk service?
無 Never
一次 Once
兩次 Twice
三次 3 times
四次或以上 4 times or above

4. 貴機構對哪些健康講座題目感興趣? What kind of health talk topics are you interested in learning about?
 

5.「企業傳訊及公共關係部」職員之服務安排 Service of Corporate Communications & Public Relations Staff
  非常滿意
Very Satisfied
滿意
Satisfied
一般
Average
不滿意
Ddissatisfied
非常不滿意
Very Ddissatisfied
不適用
Not Applicable
禮貌及主動性
Courtesy and Proactiveness
對服務內容之了解 Service Knowledge
處理時間 Processing Time
整體服務安排 Overall Arrangement

6. 講座主講者之服務安排 Service of Health Talk Speaker
  非常滿意
Very Satisfied
滿意
Satisfied
一般
Average
不滿意
Ddissatisfied
非常不滿意
Very Ddissatisfied
不適用
Not Applicable
講座安排 Overall Arrangement
講座內容Content
授課技巧Teaching Skills
時間掌握Time Management
教材運用Use of Educational Materials
服務收費Service Charge

7.貴機構會不會再考慮使用我們的服務? Will you consider using our service(s) again in future?
會 Yes
不會 No
可能會 Possibly Yes

8. 其他意見/ 建議 Other comments/suggestions
 

9. 請提供以下資料,以便我們作進一步聯絡及跟進。Please provide information below for further contact or follow-up.
姓名Name*
必須填寫Mandatory Fields.
機構/公司名稱Name of Organisation / Company*
必須填寫Mandatory Fields.
電話Telephone No.*
必須填寫Mandatory Fields.請填寫聯絡電話。請填寫8個字內的電話號內線Ext.
電郵地址E-mail Address *
必須填寫Mandatory Fields.請填寫有效電郵。
通訊地址Correspondence Address*
必須填寫Mandatory Fields.
 
閣下所提供之個人資料只供內部作存檔及統計之用,一切資料,絕對保密。
Personal information will be kept confidential and for internal use only.

10. 貴機構/公司願意繼續收取社康的服務推廣、活動、募捐及健康資訊嗎? Does your organisation/company wish to receive our information on service and programme promotions, and solicitation of donations in future?*
願意 Agree
不願意 Not Agree
  收集個人資料聲明
  Personal Information Collection Statement