晟衷医疗家族办公室服务咨询 / Dracaena Family Medical Office Membership Intake Form

晟衷医疗家族办公室：请如实详尽填写以下问题，我们将根据您的填写情况，尽快联系您。
Dracaena Family Medical Office: Please answer the following questions thoroughly. We will get in touch as soon as possible.
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1.
您的称呼:
Name:
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2.
您的联系方式:
Contact lnformation:（Phone number and e-mail address）
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3.
您是从哪里知道晟衷家族医疗办公室的?
How did you hear about Dracaena Family Medical Office?
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4.
您对晟衷家族医疗办公室感兴趣的原因是什么?
Why are you interested in Dracaena Family Medical Office?
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5.
您对什么类型的医疗照护感兴趣?(多选题)
What type of membership service are you interested in? (Multiple choice questions)【多选题】
成人标准会籍 / Standard Adult Membership
由私家医生管理，涵盖“预防→提升→诊断→治疗→康复”全程医疗及健康服务。
Full service membership managed by private physicians, covers health management from prevention→ improvement→ diagnosis→ treatment → rehabilitation
子女关爱会籍 / Pediatric Membership
主要为18岁以下的青少年生长发育跟踪、膳食营养指导、体态与运动管理等系列定制化服务。
Membership customized for adolescents under 18 years old, includes tracking of growth and development goals, personalized nutritional guidance, posture and exercise consultations.
家族会籍 / Family Membership
为家庭量身定制,包括照顾长者、关爱子女等系列化医疗定制服务。
Tailor-made for families, includes a series of customized medical services tailored for elderly and young family members.
企业会籍 / Corporate Membership
主要为公司C-Level高管提供全年的医疗及健康管理服务，具体服务模块可根据公司需求定制。
Membership includes year-round medical and health management services for the company's C-Level executives, specific service modules can be modified according to the company's needs.
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如果您是晟衷会员推荐的,请填写会员姓名或邀请码：
If you were referred by a current member, please provide their name or invite code.
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