Control No.
___ Republic of the Philippines
Department of Education
DIVISION OF TANJAY CITY
CANGHATAP ELEMENTARY SCHOOL
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 answer this form.
Client type: □ Citizen □ Business □ Government (Employee or another agency)
Date: Sex: □ Male □ Female Age:
Region of residence: Service Availed:________________________________________________
_____________________________________________________________________________________________________
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 □ 4. Not visible at all
□ 2. Somewhat easy to see □ 5. N/A
□ 3. Difficult to see
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 □ 3. Did not help
□ 2. Somewhat helped □ 4. N/A
INSTRUCTIONS:
For SQD 0-8, please put a check mark (✓) on the column that best corresponds to your answer.
Strongly Neither Agree Strongly
Disagree Disagree nor Disagree Agree Agree Not Applicable
SQDO. I am satisfied with the service that I availed.
SQD1.I spent a reasonable amount of time for my
transaction.
SQD2. The office followed the transaction’s
requirements and steps based on the information
provided.
SQD3. The steps (including payment) I needed to do
for my transaction were easy and simple.
SQD4. I easily found information about my
transaction from the office or its website.
SQD5. I paid a reasonable amount of fees for mv
transaction.
SQD6. I feel the office was fair to everyone, or
“walanq palakasari’, durinq my transaction.
SQD7. I was treated courteously by the staff, and (if
asked for help) the staff was helpful.
SQD8. 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) ___________________________________
THANK YOU!
