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華揚醫院 意見反應表
不管正面或負面的意見都歡迎,匿名表單將不予受理。
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電子郵件地址
*
有效的電子郵件地址
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當事人姓名
*
例如:劉伯溫
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連絡電話(非必填,如果您有填會比較方便本院回覆)
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性別
*
男
女
不想告知性別
想說的話
*
請詳述事情發生的相關資訊,例如發生時間、發生地點、發生事情、本院相關人員職稱等資訊…以方便本院追查真相並檢討改進。
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