Quirino State University | "Electronic Public Assistance And Complaint Desk"

Republic of the Philippines

QUIRINO STATE UNIVERSITY

Diffun, Quirino

Molding Minds, Shaping Future

Client Satisfaction Measurement (CSM)

HELP US SERVE YOU BETTER!

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 to not this form.

Client Type:

Student Faculty Staff Government (another agency) Guest Alumni Supplier

Date:

Campus Transacted: Diffun - Campus

Sex:

Male Female

Age:

Contact No.:

Service Availed (Write only the code):

(*Select the code of service availed posted in front of the office transacted.)

INSTRUCTION: Choose your answer to the Citizen's Charter(CC) questions.The Citizen's Charter is an official document that reflects the service 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?

1. I know what a CC is and I saw this office's CC.
2. I know what a CC is but NOT see this office's CC.
3. I learned of the CC only when I saw this offices's CC.
4. I do not know what a CC is and I did not see one in the office.

CC2

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

1. Easy to see
2. Somewhat easy to see
3. Difficult to see
4. Not visible at all
5. N/A

CC3

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

1. Helped very much
2. Somewhat helped
3. Did not help
4. N/A

INSTRUCTIONS:

For SQD 0-8, please choose on the column that best corresponds to your answer.

Criteria	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
SQD0. I am satisfied with the service that I availed. (Satisfaction)
SQD1. I spent a reasonable amount of time for my transaction. (Responsive)
SQD2. The office followed the transaction's requirements and steps based on the information provided. (Reliability)
SQD3. The steps (including payment) I needed to do for my transaction were easy and simple. (Access and Facilities)
SQD4. I easily found information about my transaction from the office or its website. (Communication)
SQD5. I paid a reasonable amount of fees for my transaction. (Cost)
SQD6. I feel the office was fair to everyone, or 'walang palakasan', during my transaction. (Integrity)
SQD7. I was treated courteously by the staff, and (if asked for help) the staff was helpful. (Assurance)
SQD8. I got what I needed from the government office, or (if denied) denial of request was sufficiently explained to me. (Outcome)

Suggestions on how we can further improve our services (optional):

Email address :
Choose Gmail

Client Satisfaction Measurement (CSM)

HELP US SERVE YOU BETTER!

THANK YOU!

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