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This Client Satisfaction Measurement (CSM) tracks the customer experience of government offices. Your feedback on your recently concluded transactions will help this office provide a better service.

Basic Information

Please provide your basic details below. This will help us better understand your feedback.

Control No: —

Client Type

Date

Sex

Age

Email (Optional)

Region of Residence

Office Visited

Service Availed

Name of Staff

Citizen's Charter (CC) Questions

Please answer the following questions:

Control No: —

I know what a CC is and I saw this office’s CC

I know what a CC is but I did NOT see this office’s CC

I learned of the CC only when I saw this office’s CC

I do not know what a CC is and I did not see one in this office

Easy to see

Somewhat easy to see

Difficult to see

Not visible at all

N/A

Helped very much

Somewhat helped

Did not help

N/A

Service Quality Dimensions (SQD)

Please answer the following questions. Use the scale below to indicate your level of agreement with each statement:

1 - Strongly Disagree, 2 - Disagree, 3 - Neither Agree nor Disagree, 4 - Agree, 5 - Strongly Agree, 6 - N/A (Not Applicable)

Control No: —

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

How we can further improve our services? Optional

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Basic Information

Citizen's Charter (CC) Questions

Which of the following best describes your awareness of a Citizen’s Charter (CC)?

If aware of CC (answered 1-3 on CC1), would you say that the CC of this office was…?

If aware of CC (answered 1-3 in CC1), how much did the CC help you in your transaction?

Service Quality Dimensions (SQD)

I am satisfied with the service that I availed.

I spent a reasonable amount of time for my transaction.

The office followed the transaction’s requirements and steps based on the information provided.

The steps (including payment) I needed to do for my transaction were easy and simple.

I easily found information about my transaction from the office or its website.

I paid a reasonable amount of fees for my transaction.

I feel the office was fair to everyone, or “walang palakasan”, during my transaction.

I was treated courteously by the staff, and (if asked for help) the staff was helpful.

I got what I needed from the government office, or (if denied) denial or request was sufficiently explained to me.