DOTr - CSM (English)

Client Satisfaction Measurement (CSM) Questionnaire

Client Type:*

Citizen

Business

Government (Employee or another agency)

Date:*

Sex:*

Male

Female

Age:*

0 to 19 years old

20 to 39 years old

40 to 59 years old

60 to 79 years old

80 years old and above

Region of residence (Ex: If resident of San Pedro, Laguna - IVA, Quezon City - NCR, Pampanga- 3 or III):*

Office/Service/Division where you avail of service/s.*

Service Availed:*

CC INSTRUCTIONS:

Check mark (✔ ) 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?*

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

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

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

4. I do not know what a CC is and I did not see one in this office. (Answer ‘N/A’ on CC2 and CC3)

CC2 If aware of CC (answered 1-3 in 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

N/A

CC3 If aware of CC (answered codes 1-3 in 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

SQD INSTRUCTIONS:

For SQD 0-8, please put a check mark (✔ ) on the column that best corresponds to your answer.

😀
Strongly Agree

🙂
Agree

😐
Neither Agree nor Disagree

🙁
Disagree

😦
Strongly Disagree

N/A
Not Applicable

SQD0. I am satisfied with the service that I availed.*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Not Applicable

SQD1. I spent a reasonable amount of time for my transaction.*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Not Applicable

SQD2. The office followed the transaction’s requirements and steps based on the information provided.*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Not Applicable

SQD3. The steps (including payment) I needed to do for my transaction were easy and simple.*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Not Applicable

SQD4. I easily found information about my transaction from the office or its website.*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Not Applicable

SQD5. I paid a reasonable amount of fees for my transaction. (If the service was free, mark the ‘N/A’ column)*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Not Applicable

SQD6. I feel the office was fair to everyone, or “walang palakasan”, during my transaction.*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Not Applicable

SQD7. I was treated courteously by the staff, and (if asked for help) the staff was helpful.*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Not Applicable

SQD8. I got what I needed from the government office, or (if denied) denial of request was sufficiently explained to me.*

Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Not Applicable

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

Email address (optional):

Client Satisfaction Measurement (CSM) Questionnaire

HELP US SERVE YOU BETTER!

CC INSTRUCTIONS:

SQD INSTRUCTIONS: