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戒菸訓練實行現況問卷—高雄場次
高階課程結束後，至今所遇到的種種現況調查
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Email
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身分證字號
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第一部份
個人基本資料
服務機構
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年齡(實歲)
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1.性別
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0.女
1.男
2.您已經和衛生福利部國民健康署簽訂「醫事機構戒菸服務補助計畫契約書」並使用「健保資訊網服務系統(VPN)—醫療院所戒菸服務」
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0.已簽約
1.申請簽約中
2.未來三個月會簽約
3.尚未取得高階戒菸資格
4.沒有計畫簽約
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