Put a section for their name, gender, age

Name:
Gender:
Age:

1. How often do you visit this polyclinics/clinics/hospitals for medical

treatment/consultations?

A. Every 5 months or above

B. Every 2-4 months

C. Once a month

D. 2 or more times a month

2. The sector segment of service in the polyclinics/clinics/hospitals which

takes up most of yourthat you feel takes up most of the waiting time is:

A. Booking appointments

B. Before or between consultations

C. During consultations

D. Collecting medicinePharmacy

3. From what you can recall lately, Wwhat is the average total waiting time
for your entire visit to the this polyclinics/clinics/hospitals?

A. 30 minutes and below

 B. 30 – 60 minutes

C. 1 – 2 hours

D. More than 2 hours

How do you link the previous segment and the following segment
4. Have you misplaced or lost your cell phone before?
Yes / No

If yes, number couofnt the durationtime(s): (hrs)

5. Do you think it is practical to install Would you include the an alerting

device which (explain its main functions) in your phone?
Yes / No

How do you link from the previous segment to this?

6.
Yes/No
Do you like to wear accessories? eg. Necklaces

How do you link?

7. The number of breaks given per working day by your

company is sufficient for you.
• Yes

• No
relieve stress.
8. Comedy videos and relaxation music can help you to

• Yes

• No

9. If your company were to give you a 5-mins break after

every 1 hour of work, will it enhance your performance at work?
• Yes it will

• No it wouldn’t

• Maybe it will

10. Do you think there is anymore improvement for this device? What
is/are the suggestion(s) you have for our proposed device?

I can see that you have quite a number of interesting questions designated, I
encourage you to look through the questions and work on the smoothness of the
flow of your questions, & think about what kind of data you want to collect and
how do you want to do your analysis using all the data.