JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
112年血液透析單位導入感染管制自我評核機制先驅研究
感謝各位院所意願參與本計畫﹐煩請清楚填寫以下資料﹐以利往後
資料寄送聯繫
報名相關聯絡資訊
助理︰林莉婷
電話︰07-3121101#5090
信箱︰linlitene@gmail.com
Sign in to Google
to save your progress.
Learn more
* Indicates required question
醫療院所名稱
*
Your answer
地區縣市(ex:高雄市)
*
Your answer
醫療院所地址
*
Your answer
院所層級
*
基層診所
地區醫院
區域醫院
醫學中心
透析床數
*
Your answer
聯絡人姓名
*
Your answer
職稱(ex :醫師、護理師、感管師)
*
Your answer
聯絡電話
*
Your answer
聯絡信箱
*
Your answer
若您有其他建議或疑問﹐歡迎向我們提出。
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms