预约表格 Appointment Request Form
本中心确保不会利用您的个人资料进行任何的交易或向任何第三方泄露您的信息。
所提供的辅导服务拥有固定的费用。
预约的确认将在1至3个工作天内,以WhatsApp: 011-6530 9722 或电邮方式发出。
我们将尽可能的根据您的选项做出合适的安排。
如您有任何问题,请随时与本中心联系 03-7785 5955。谢谢。
Please note that we do not rent or sell your information to any third parties!
Service provided with a standard fee and charges.
Appointment will be confirmed in 1-3 working day by WhatsApp: 011-65309722 / email.
We will try our best in meeting your preferences, should there be any discrepancies please feel free to contact us at 03-7785 5955!
温馨提醒 Reminder
这个表格只是方便在总会的预约。其他分会的预约请直接拨电给该分会。谢谢
This online appointment form only made for MAIN HQ. Please call to our branch directly if you want to make appointment at other branch. Thank you.
重要告示 Important Notice
基于新型冠状病毒(Covid-19)的疫情,本中心将尽力配合卫生部以及行动限制令,以防止病毒的扩散。如果您在过去14天内从国外回来,或是目前身体出现类似流感的症状,如:发烧、咳嗽等,请联络我们更改您的预约时间或是选择线上视讯辅导。 Due to the situation with Coronavirus (Covid-19), we are doing our best to prevent the spread of the virus in compliance with Ministry of Health and MCO. If you have just returned from foreign country in the past 14 days, or are exhibiting flu-like/ fever/ cough symptoms, please call us to reschedule your appointment or choose online video call counselling.
地点首选 Preferred Venue *
Required
姓名 Name (As per I/C) *
电邮 Your E-mail *
联络号码 Your Phone number *
为谁安排预约? The appointment is for? *
性别 Gender *
年龄 Age *
你需要哪一种类的辅导服务? You would like to request for which type of counselling? *
Required
实体辅导服务须知 Note on Counselling service in Centre
1. 个案和家属(只限一人陪同)都配戴口罩。Clients and family member (only ONE person)
MUST wear mask.
2. 使用消毒液洗手。Use hand sanitizer.
3. 遵守社交距离1公尺。Keep social distance of 1 meter.
4. 测量体温。Take body temperature.
5. 填写健康监测表。Fill in health screening form.
线上视讯辅导服务须知 Note on Online Video Call Counselling service
1. 具备稳定的网络和安静的空间。Stable internet connection and quiet surrounding.
2. 建议你戴耳机。It would be good if using earphone
3. 获取线上链接与辅导员联系。Obtain link that connect to counsellor.
4. 15分钟前在线上做准备。Prepare to online 15 minutes before session time.
4. 必须允许麦克风和摄像头开启 。Must enable camera and audio/mic.
5. 切记:禁止在辅导过程中录音或录影。 Remember: Voice or video recording are prohibited.
语言首项 (可以多项选择)Preferred language that best to express oneself (can select more than 1) *
Required
你所面对的问题 In presenting issue *
Required
简单描述您所面对的问题,若您无法找到以上选项 Briefly describe your presenting issue if you are unable to find the description above
前来接受辅导的个案有自杀念头吗? Do the person seeking counselling have suicidal thoughts? *
前来接受辅导的个案有吃药吗? Do the person seeking counselling under medication? *
日期首选 Preferred Date *
Required
时间首选 Preferred Time *
Submit
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