Clientele Satisfaction Survey
We want to know your feedback to our services. Help us serve you better! 

This Clientele Satisfaction Survey (CSS) 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 to not answer this form. 
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Client Type *
Required
Date 
MM
/
DD
/
YYYY
Sex 
Age
Address
Service Availed  *
Required
Citizen's Charter 
INSTRUCTIONS: Check mark your answer to the Citizen's Charter question. The Citizen's Charter document is an official document that reflects the services of the government agency/office including its requirements, fees, and processing times among others. 
CC1: Which of the following best describes your awareness of CC? 
CC2: If aware of CC (answered 1-3 of CC1), would you say that the CC of this office was...?
CC3: If aware of C, (answer 1-3 of CC1), how much did the CC helped you in your transaction? 
Clientele Satisfaction Survey 
For SQD 0-8, please put a check mark on the column that best corresponds to your answer. 
SQD0. I am satisfied with the service that I availed.  *
Required
SQD1. I spent a reasonable amount of time for my transaction.  *
Required
SQD2. The office followed the transaction's requirements and steps based on the information provided.  *
Required
SQD3. The steps (including payment) I needed to do for my transaction were easy and simple.  *
Required
SQD4. I easily found information about my transaction from the office or its website.  *
Required
SQD5. I paid a reasonable amount of fees for my transaction. (If service was free, mark the 'N/A' column) *
Required
SQD6. I feel the office was fair to everyone, or "walang palakasan", during my transaction.  *
Required
SQD7. I was treated courteously by the staff, and (If asked for help) the staff was helpful.   *
Required
SQD8. I got what I needed from the government office, or (if denied) denial of request was sufficiently explained to me.  *
Required
Suggestions on how we can further improve our services (optional): 
Email Address (optional): 
THANK YOU!
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