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心田-諮商預約表單 reservation for counseling services
歡迎你來心田走走
靠近自我,滋養心中的田園。

Welcome to Hsin-Tien!

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【預約流程說明 How to make a reservation】
在開始預約諮商前,有些例行作業得讓您知道:
1. 心田在收到您的表單後,會在盡快用【電話】聯繫您,進行15-20分鐘談話來了解您的需求。
2. 依您的需求、預算,及可以諮商的時間安排適合的心理師。
3. 以電話或e-mail通知您確定的第一次諮商時間。

注意:
1. 費用部分,會依照心理師的資歷;個別/伴侶/家庭諮商而有不同,大致為1600-4500元/50-90分鐘不等。(僅收現金)
2. 本所電話為02-7749開頭,來電,確保可以不被打擾進行初談喔~

Before making an appointment, there is some information that we would like to share with you:
(1) Upon receiving your application, we will promptly contact you to schedule an intake that typically lasts 15-20 minutes.
(2) Based on your needs, concerns, budget, and availability, we will assign a psychologist for you.
(3) The date and time for your first counseling session will be communicated to you via phone or email.

Notice!!!
(1)The price of counseling depends on each psychologist's specialization. The range is between 1600 to 4500 NTD per 50-90 mins.
(2)Our phone number is +886-2-7749-57XX  


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姓名 Name
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出生日期(西元年/月/日) Date of birth
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E-mail (或line ID) E-mail or Line ID
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手機號碼(或連繫得到本人的電話號碼) Phone number
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方便電話聯繫的時段 Available time for phone intake
請於下列表格,盡量多勾選一點時間,以利我們盡速與您電話初談
【目前晚間初談人力較不足,敬請選擇其他尚可接電話的時段喔~】
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週間 Available time during the week
Question Type
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週一 Monday
週二 Tuesday
週三 Wednesday
週四 Thursday
10:00-13:00
13:00-15:00
15:00-18:00
18:00-21:00
Rows
1.
10:00-13:00
2.
13:00-15:00
3.
15:00-18:00
4.
18:00-21:00
5.
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Columns
週一 Monday
週二 Tuesday
週三 Wednesday
週四 Thursday
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週末 Available time on weekend
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週五 Friday
週六 Saturday
10:00-13:00
13:00-15:00
15:00-17:00
Rows
1.
10:00-13:00
2.
13:00-15:00
3.
15:00-17:00
4.
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Columns
週五 Friday
週六 Saturday
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您想來心田談些什麼? what would you like to talk about during your counseling sessions?
Question Type
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情緒困擾 emotional issues
壓力調適 stress management
生涯規劃 career management
人際關係 interpersonal relationship
家庭關係 family relationship
親子關係 parent-child relationship
親密關係 intimate relationship
性別議題 gender/sexual issues
健康狀況 health concern
自我探索 self-exploration
other
Other…
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請簡單敘述一下,上面提到您想談的主題。As stated above, please describe the topics you want to talk about in counseling.
Question Type
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是否有想預約的心理師?如有請寫下心理師的姓名。Whom would you like to make an  appointment with?
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如何知道師大心田? How Did You Hear About Us
Question Type
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自己網路搜尋 (臉書、心田官網、line等) Searching the Web for information
親友介紹 Recommended by friends and relatives
其他單位介紹(學校、政府部門、醫療院所等) Refered by other departments (e.g. schools, hospitals)
本所DM文宣 Our DM or e-DM
Other…
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其他想跟我們說的 Other information
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我們會盡快用電話聯繫您,再請您隨時留意來電。We will contact you as soon as possible!
聯絡電話 phone number:(02)7749-5720(櫃台總機)
聯絡時間 Hours:週一至週五早上10:00 至 晚上21:00 /週六早上09:00-下午17:00
電子信箱 E-mail:ntnu.community@gmail.com
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【預約流程說明 How to make a reservation】
姓名 Name
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出生日期(西元年/月/日) Date of birth
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E-mail (或line ID) E-mail or Line ID
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手機號碼(或連繫得到本人的電話號碼) Phone number
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方便電話聯繫的時段 Available time for phone intake
週間 Available time during the week
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週末 Available time on weekend
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您想來心田談些什麼? what would you like to talk about during your counseling sessions?
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請簡單敘述一下,上面提到您想談的主題。As stated above, please describe the topics you want to talk about in counseling.
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是否有想預約的心理師?如有請寫下心理師的姓名。Whom would you like to make an  appointment with?
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No responses yet for this question.
如何知道師大心田? How Did You Hear About Us
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其他想跟我們說的 Other information
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我們會盡快用電話聯繫您,再請您隨時留意來電。We will contact you as soon as possible!
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