Basic information of respondent

Name:

Age:

Identity: patient / family member of patient

Telephone:

Questions

1. Is the Passageway crowed?

A yes B no C indifferent

2. Which one will you choose if you want to use lift or stairway (according to service desk)?

A the left B the middle C the right

3. Is it convenient if you want to air clothes in hospital?

A yes B no C indifferent

4. Do you feel it is a trouble if anyone has a rest or smoking in stairway?

A yes B no C indifferent

5. Is it convenient that the restroom and drinking-water supplying system shared same area?

A yes B no C indifferent

6. Is visual guide efficient to remind exit way in stairway?

A yes B no C indifferent

7. Is visual guide efficient to remind slipping in passageway?

A yes B no C indifferent

8. Is visual guide efficient to remind correct use of fire hydrant, extinguisher, and alarm?

A yes B no C indifferent

Other advice or suggestion