Citizen Charter Feedback

BILIRAN PROVINCE STATE UNIVERSITY

HELP US SERVE YOU BETTER!

In compliance with the Data Privacy Act of 2012 (Republic Act No. 10173), this Client Satisfaction Measurement (CSM) form is issued to track and improve the customer experience of government offices. By proceeding, you acknowledge that the personal information you provide will be processed solely for the purpose of evaluating government services and enhancing service delivery. The data gathered will be used exclusively for internal analytics, reporting, and program improvement by this office. We are committed to protecting your privacy; all personal information shared will remain confidential and will not be disclosed for any other purpose without your consent. Participation is voluntary, and you have the option to withhold personal information or refrain from answering the form entirely.

Name (optional)

If not provided, we'll record as "Unknown".

Client type

Date

Sex

Age

Region of residence

Office

Service Availed

Services will appear after you choose an office.

Citizen 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.

CC2. If aware of CC, 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, how much did the CC help you in your transaction?

1. Helped very much

2. Somewhat helped

3. Did not help

4. N/A

Service Quality Dimensions (SQD)

Please indicate your level of agreement:

Statement	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree	N/A
SQD 0. I am satisfied with the service that I availed
SQD 1. I spent a reasonable amount of time for my transaction
SQD 2. The office followed the transaction's requirements and steps based on the information provided
SQD 3. The steps (including payment) I needed to do for my transaction were easy and simple
SQD 4. I easily found information about my transaction from the office or its website
SQD 5. I paid a reasonable amount of fees for my transaction. (If service was free, mark the N/A column)
SQD 6. I feel the office was fair to everyone, or "walang palakasan" during my transaction
SQD 7. I was treated courteously by the staff, and (if asked for help) the staff was helpful
SQD 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)

We'll only use this to follow up on your feedback if needed.