PART 1 OF 4

This Client Satisfaction Measurement (CSM) tracks the customer experience of government offices. Your feedback on your recently concluded transaction will help this office provide a better service. Personal information shared will be kept confidential and you always have the option not to answer this form.

Client Type:


Service/s Availed:


PART 2 OF 4

INSTRUCTION : Check mark (✓) your answer to the Citizen's Charter (CC) questions. The Citizen's Charter is an official document that reflects the services of a government agency/office including its requirements, fees, and processing times among others.
(Panuto/Tagubilin: Lagyan ng tsek (✓)) ang iyong sagot sa mga tanong tungkol sa Citizen's Charter (CC). Ang Citizen's Charter ay isang opisyal na dokumento na nagpapakita ng mga serbisyo ng isang ahensya/opisina ng gobyerno kabilang ang mga rekwayrment, bayad, at oras ng pagproseso nito at iba pa)

CC1: Which of the following best describes your awareness of a Citizen's Charter (CC)?
[Alin sa mga sumusunod ang lubos na naglalarawan sa iyong kaalaman tungkol sa Citizen’s Charter (CC)?]


CC2: If aware of Citizen’s Charter (CC) (answered 1-3 in CC1), would you say that the Citizen’s Charter (CC) of this office was . . .?
[Kung alam mo ang tungkol sa Citizen’s Charter (CC), masasabi mo bang ang CC sa isang opisina ay..?]


CC3: If aware of Citizen’s Charter (CC) (answered codes 1-3 in CC1), how much did the Citizen’s Charter (CC) help you in your transaction?
[Kung alam ang mo ang tungkol sa Citizen’s Charter (CC), paano nakatulong ito sa mga transaksyon mo?]


PART 3 OF 4

INSTRUCTIONS: For SQD 0-8, please put a checkmark (✓) on the column that best corresponds to your answer.
(Panuto/Tagubilin: Para sa SQD 0-8, Lagyan ng (✓) ang hanay na pinakaangkop sa iyong sagot)

SQD0: I am satisfied with the service that I availed.
(Nasiyahan ako sa serbisyong natanggap.)


Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree

SQD1: I spent a reasonable amount of time for my transaction.
(Gumugugol ako ng makatwirang halaga ng oras para sa aking transaksyon.)


Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree

SQD2: The office followed the transaction’s requirements and steps based on the information provided.
(Sinunod ng opisina ang mga kinakailangang hakbang para sa mga transaksyon batay sa impormasyong naibigay.)


Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree

SQD3: The steps (including payment) I needed to do for my transaction were easy and simple.
(Ang mga hakbang (kabilang na ang pagbabayad) na kailangan kong gawin para sa aking transaksyon ay madali at simple.)


Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree

SQD4: I easily found information about my transaction from the office or its website.
(Madali akong nakahanap ng impormasyon tungkol sa aking transaksyon mula sa opisina o sa website nito.)


Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree

SQD5: I paid a reasonable amount of fees for my transaction.
(Nagbayad ako ng makatwirang halaga para sa aking transaksyon.)


Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree

SQD6: I feel the office was fair to everyone, or “walang palakasan”, during my transaction.
(Pakiramdam ko ay patas ang opisina sa lahat, o “walang palakasan”, sa isinagawang transaksyon.)


Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree

SQD7: I was treated courteously by the staff, and (if asked for help) the staff was helpful.
(Magalang akong trinato ng staff, at (kung hihingi ako ng tulong) handa siyang tumulong.)


Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree

SQD8: I got what I needed from the government office, or (if denied) denial of request was sufficiently explained to me.
(Nakuha ko ang kailangan ko mula sa opisina ng gobyerno, o (kung tinanggihan) ang pagtanggi sa kahilingan ay ipinaliwanag sa akin.)


Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
Strongly Disagree
PART 4 OF 4

COMMENTS AND SUGGESTIONS:
(Komento at mungkahi):

How can we further improve our services? (Optional)
(Paano pa namin mapapabuti ang aming serbisyo? (Opsyonal)


E-mail Address (Optional)

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