有关自我隔离的调查问卷
感谢您能抽出几分钟时间来参加本次调查问卷。
您是在哪里被隔离的?
Where were you isolated?
酒店隔离Hotel isolation
居家隔离Home Isolation
其他Other
如果给您的隔离地点的环境打分您会打几分?(一星为最低,五星为最高)
If you were to rate the environment of your isolated location how would you rate it? (One star is the lowest, five stars is the highest)
选项1 ★ ★ ★ ★ ★
这个评分有什么具体原因吗?
Is there a specific reason for this?
____________
您被隔离了多长时间?
How long have you been in isolation?
____________
您在隔离时期与工作人员的交流与相处有什么感受吗?
How did you feel about interacting with the staff during your time in quarantine?
____________
您在隔离时期有通过什么方式进行自我排解吗?
Were there any ways that you were able to detoxify yourself during the isolation period?
____________
您在隔离的时候有什么特殊的感受或是经历吗?
Did you have any special feelings or experiences when you were in isolation?
____________
您在隔离结束时有什么感受吗?
Did you have any feelings at the end of the quarantine?
____________
您在隔离之后最想做的一件事是什么
?
What is the one thing you would most like to do after quarantine?
____________
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