1. Bagaimana Pendapat Saudara tentang Kesesuaian Syarat yang harus dipenuhi dengan jenis pelayanan yang di mohon ?
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Tidak Sesuai
Kurang Sesuai
Sesuai
Sangat Sesuai
Other…
Other…
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or
add "Other"
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Mohon Masukan / Pendapat Saudara :
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Question
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Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
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Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
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(0 points)
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2. Bagaimana Pemahaman Saudara tentang Alur Prosedur dalam Pengurusan Suatu Jenis Pelayanan Unit Ini?
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Tidak Mudah
Kurang Mudah
Mudah
Sangat Mudah
Other…
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add "Other"
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Mohon Masukan / Pendapat Saudara :
*
Question
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
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3. Bagaimana Pendapat Saudara tentang Kesesuaian Antara Standar Waktu yang Ditetapkan dengan Kenyataan dalam Penyelesaian suatu Jenis Pelayanan ?
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Question
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Question Type
Short answer
Paragraph
Multiple choice
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Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Tidak Sesuai
Kurang sesuai
Sesuai
Sangat Sesuai
Other…
Other…
Add option
or
add "Other"
…
Select at least
Select at most
Select exactly
Number
Custom error text
Answer key
(0 points)
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Mohon Masukan / Pendapat Saudara :
*
Question
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
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4. Bagaimana pendapat saudara tentang besaran biaya / tarif atas suatu jenis pelayanan ?
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Question
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Sangat Mahal / Tidak sesuai dengan yang ditetapkan
Cukup Mahal / Kurang sesuai dengan yang ditetapkan
Murah meskipun kurang sesuai dengan yang ditetapkan
Sesuai tarif yang ditetapkan ( bagi Pelayanan yang berbiaya ) / gratis ( bagi pelayanan yang tidak berbayar )
Other…
Other…
Add option
or
add "Other"
…
Select at least
Select at most
Select exactly
Number
Custom error text
Answer key
(0 points)
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Mohon Masukan / Pendapat Saudara :
*
Question
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
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5. Bagaimana pendapat saudara tentang hasil pelayanan yang diberikan atau diterima pengguna layanan sesuai dengan ketentuan yang telah tercantum dalam standar pelayanan ?
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Question
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Tidak Sesuai
Kurang sesuai
Sesuai
Sangat Sesuai
Other…
Other…
Add option
or
add "Other"
…
Select at least
Select at most
Select exactly
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Mohon Masukan / Pendapat Saudara :
*
Question
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
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6. Bagaimana Pendapat Saudara tentang Kompetensi / Kemampuan Petugas dalam Memberikan Pelayanan ?