(ON-SITE/ENGLISH) CLIENT SATISFACTION MEASUREMENT SURVEY
This CSM tracks the customer experience of government offices. Your feedback on your recently concluded transaction will help this office to provide a better service. Personal information shared will be kept confidential  and you always have the option not to answer this form.
Email *
Department: *
Client Type: *
Date *
MM
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DD
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YYYY
Sex *
Age *
Region of residence: *
Service Availed: *
INSTRUCTIONS: Choose 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.
CC1     
Which of the following best describes your awareness of a CC?
 *
CC2
If aware of CC (answered 1-3 in CC1), would you say that the CC of this office was...?
 *
CC3
If aware of CC (answered 1-3 in CC1), how much did the CC help you in your transaction?
 *
INSTRUCTIONS: For Service Quality Dimension 0-8, please choose the option that best corresponds to your answer. 
0. I am satisfied with the service I availed. *
1. I spent a reasonable amount of time for my transaction. *
2. The office followed the transaction requirements and steps based on the information provided. *
3. The steps (including payment) I needed to do for my transaction were easy and simple. *
4. I easily found information about my transaction from the office or its website. *
5. I paid a reasonable amount of fees for my transaction. (if service was free, mark the N/A box) *
6. I feel the office was fair to everyone "walang palakasan"  during my transaction. *
7. I was treated courteously by the staff, and (if asked for help) the staff was helpful. *
8. I got what I needed from the government office, or (if denied) denial of request was sufficiently explained to me. *
Suggestions on how we can further improve our services (optional):
Email address (optional)
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