第一部分 Part I


  1. Why are you interested in using the oral health cards for special needs?
    為什麼對這套給予特殊需要人士的口腔健康卡感到興趣？
    • for personal use to train person with special needs 為個人使用，以訓練有特殊需要的人
    • for self-knowledge 用以為增進個人知識
    • for use in school/classes 在學校/課堂上使用
       
  2. Do you have any family members/relatives/close friends with special needs?
    有家人/親戚/親密朋友是特殊需要人士嗎？
    • No 沒有
    • Yes 有 (family members 家人/ relatives 親戚/ close friends 親密朋友)
    3.  
  3. Where did you heard about the oral health cards?
    你是從哪裡知道這套口腔健康卡？
    • media (newspaper, magazine, television) 媒體（報紙，雜誌，電視）
    • health organization/society (e.g. Heep Hong Society) 健康機構（如協康會）
    • medical/health care center 醫療/保健中心
    • school 學校
    • dentist 牙科醫生
    • friend 朋友
    • others 其他
       
  4. Do you like to participate in the evaluation programme of the oral health cards for special needs? You will be required to complete a questionnaire about your experience with the health cards only after three months.
    你願意參與評核這套給予特殊需要人士的口腔健康卡嗎？你只需要在三個月後回答一份問卷，分享你在使用口腔健康卡的經驗。
    • Yes 願意 (Please give us your e-mail address for contacting you regarding the evaluation programme: 請給予你的電郵地址以跟你在稍後就此聯絡：
      ）
    • No 不願意


Statement of Purposes in respect of Collection of Personal Data


Purpose of Collection

  1. The data provided will be used by the Hong Kong Society of Paediatric Dentistry for evaluating the oral health care sequence cards project. All the personal data are provided on voluntary basis.
  2. The Personal data provided are mainly for use within the Hong Kong Society of Paediatric Dentistry. They may only be disclosed to parties where for whom you have given consent to such disclosure or where such disclosure is allowed under the Personal Data (Privacy) Ordinance.
  3. You have the right of access and correction with respect to personal data as provided for in Sections 18 and 22 and Principle 6 of Schedule 1 of the Personal Data (Privacy) Ordinance.
  4. Enquiries concerning the personal data collected by means of this instrument, including requests for access to and correction of data, should be directed to the Honorary Secretary, Hong Kong Society of Paediatric Dentistry, Paediatric Dentistry and Orthodontics, 2/F., Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong

個人資料收集聲明


收集資料的目的

  1. 所提供的個人資料，主要由香港兒童齒科學會用於評估口腔健康卡。所有提供的個人資料均為自願的。
  2. 所提供的個人資料，主要由香港兒童齒科學會內部使用。資料只會在其本人同意，又或是《個人資料（私隱）條例》所容許下，才會向其他相關人士披露。
  3. 根據《個人資料（私隱）條例》第 18條及 22條以及其附表 1第 6原則所述，閣下有權查閱及修正個人資料。
  4. 查閱及更正資料的要求收集的個人資料有任何查詢，應直接聯絡香港兒童齒科學會名譽秘書，香港香港西營盤醫院道34號香港大學菲臘牙科醫院兒童齒科及矯齒科。

Acknowledgement: This project is funded by the S.K. Yee Medical Foundation. (Project No.: 213025)
鳴謝: 本計劃是由余兆麒醫療基金資助。(計劃編號: 213025）

The oral health cards are not for commercial use.
口腔健康卡不得作商業用途。


遞交及下載口腔健康卡
Submit and download Oral Health Cards