臨床心理及心理輔導服務 - 網上查詢
Clinical Psychology and Counselling Services - Online Enquiry
聯絡人姓名 Contact Person *
Your answer
聯絡電話 Contact number *
Your answer
服務使用者姓名 Client's Name
(若與聯絡人不同 if different from Contact Person)
Your answer
服務使用者性別 Client's Gender *
服務使用者年齡 Client's Age *
所需服務 Required Services *
可選多於一項 You can select more than one option.
Required
輔導服務範圍 Counselling Services Areas *
可選多於一項 You can select more than one option.
Required
希望約見時間 Availability for Meeting
可選多於一項 You can select more than one option.
早上 AM
下午 PM
星期一 Monday
星期二 Tuesday (*下午時段至晚上九時正 Appointment available till 9pm)
星期三 Wednesday
星期四 Thursday (*下午時段至晚上九時正 Appointment available till 9pm)
星期五 Friday
星期六 Saturday
其他資料或查詢 Other Information or Enquiries
Your answer
如何得悉本中心的服務 ? How do you know our psychological & counselling services? *
可選多於一項 You can select more than one option.
Required
閣下所提供之個人資料只供內部作存檔之用,一切資料絕對保密。All information provided are for internal use only and will be kept strictly confidential.
收到您的查詢後,我們將於3個工作天內與閣下聯絡並安排相關輔導服務,謝謝。
We will contact you within three working days upon receiving your enquiry to arrange counselling appointment. Thank you.
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