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MNWD CLIENT SATISFACTION MEASUREMENT FORM
This short Client Satisfaction Measurement (CSM) survey aims to track the customer experience of government offices. Your answers will enable this office to provide a better service.
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* Indicates required question
Email (Optional)
Your answer
Age:
*
19 and below
20 - 29
30 - 39
40 - 49
50 - 59
60 and above
City/Municipality
*
Choose
Naga City
Camaligan
Canaman
Magarao
Gainza
Milaor
Pili
Sex:
*
Male
Female
Service Availed:
*
Choose
Reopening of Water Service Connection within two (2) days-same meter
Reconnection of Disconnected Water Service Connection after two(2) days to sixty(60) days
Reconnection of Water Service Connection disconnected for more than sixty (60) days
Disconnection of Water Service Connection upon request
Senior Citizens' discount application
Person's with disability discount application
Change of Registration application
Inspection/Verification of reported illegal connections
Notice of adjusted billing
Meter readers' field findings, request for repair & other water service related
Re-tapping of Water Service Connection
Water sales to private water
Sales of bidding documents
Water meter testing/certification
Water sales thru lorry to other stakeholders
Bacteriological Analysis
Physical and Chemical Analysis
Water service extension to a subdivision
Tree Growing
Speaking engagement
Payment of water bill
Collection of other payments
Disbursement of approved checks
Processing of disbursement voucher (payment to supplier)
Customer Type:
*
Citizen
Business (Visited for business purposes)
Government (Employee or another agency)
INSTRUCTIONS:
Select your answer to the Citizen's Charter (CC) questions.
CC1.
Do you know about the Citizen’s Charter (document of an agency’s services and requirements)?
*
1. Yes, aware before my transaction with this office
2. Yes, but aware only when I saw the CC of this office
3. No, not aware of the CC (Skip questions CC2 and CC3)
CC2.
If
Yes
to the previous question, did you see this office’s Citizen’s Charter?
*
1. Yes, the CC was easy to find
2. Yes, but the CC was hard to find
3. No, I did not see this office’s CC (Skip question CC3)
CC3.
If
Yes
to the previous question, did you use the Citizen’s Charter as a guide for the service/s you availed?
*
1. Yes, I was able to use the CC
2. No, I was not able to use the CC
INSTRUCTIONS:
For SQD 1-8, please select the number that corresponds to your answer
SQD0.
I am satisfied with the service that I availed
*
1. Strongly Disagree
2. Disagree
3. Neither Agree nor Disagree
4. Agree
5. Strongly Agree
6. N/A
SQD1.
I spent an acceptable amount of time to complete my transaction
(Responsiveness)
*
1. Strongly Disagree
2. Disagree
3. Neither Agree nor Disagree
4. Agree
5. Strongly Agree
6. N/A
SQD2.
The office accurately informed and followed the transaction’s requirements and steps
(Reliability)
*
1. Strongly Disagree
2. Disagree
3. Neither Agree nor Disagree
4. Agree
5. Strongly Agree
6. N/A
SQD3.
My online transaction (including steps and payment) was simple and convenient
(Access and Facilities)
*
1. Strongly Disagree
2. Disagree
3. Neither Agree nor Disagree
4. Agree
5. Strongly Agree
6. N/A
SQD4.
I easily found information about my transaction from the office or its website
(Communication)
*
1. Strongly Disagree
2. Disagree
3. Neither Agree nor Disagree
4. Agree
5. Strongly Agree
6. N/A
SQD5.
I paid an acceptable amount of fees for my transaction
(Costs)
*
1. Strongly Disagree
2. Disagree
3. Neither Agree nor Disagree
4. Agree
5. Strongly Agree
6. N/A
SQD6
. I am confident my online transaction was secure
(Integrity)
*
1. Strongly Disagree
2. Disagree
3. Neither Agree nor Disagree
4. Agree
5. Strongly Agree
6. N/A
SQD7.
The office's online support was available, or (if asked questions) online support was quick to respond
(Assurance)
*
1. Strongly Disagree
2. Disagree
3. Neither Agree nor Disagree
4. Agree
5. Strongly Agree
6. N/A
SQD8.
I got what I needed from the government office
(Outcome)
*
1. Strongly Disagree
2. Disagree
3. Neither Agree nor Disagree
4. Agree
5. Strongly Agree
6. N/A
Remarks (Optional):
Your answer
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