健康評估表及服務查詢 Health Needs Assessment and Service Enquiry
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Medical Condition 
照顧對象健康情況 
(Can select more than one 可多選)
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Required
服務需求
Required Service(s)
(Can select more than one 可多選) 
*
Required
你所需要的醫護人員
Required Health Care Personnel
(Can select more than one 可多選) 
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