Address: 11/F, The Hong Kong Federation of Youth Groups Building, 21 Pak Fuk Road, North Point, Hong Kong
Tel: 2511 2235 Fax: 2507 2417
请转介您身边需协助的长者资料给我们。他们需要您的帮助!
Please refer the information of in-need-elders
to us. They need your help!
转介个案表格
Case Referral Form (需协助长者Elder-in-need)
姓名
Name:
性别
Sex:
男Male
女Female
年龄
Age:
地址
Address:
联络方法
Contact Method:
需协助原因
Reasons for Assistance:
转介者Referrer
姓名
Name:
联络电话
Contact Tel:
备注
Remarks:
本会将尽快与该名长者联络，并转介至所属地区之本会服务单位或其他有关机构跟进
We will contact the elder-in-need as soon as possible, and refer
the case to our service units/other organizations to follow up
以上个人资料只用作处理转介用途
The above personal information is for case referral purpose only
