ADMINISTRATIVE SERVICE - RECORDS DIVISION
Your experience matters to us! (Ang iyong karanasan ay mahalaga sa amin!)

Privacy Notice:
The personal information included in this document should only be used for the purposes of administering the survey. Any personal information included herein may not be used for other purposes aside from those stated above.
(Ang mga personal na impormasyon sa dokumentong ito ay maaari lamang gamitin para sa layunin ng survey na ito. Hindi ito gagamitin sa iba pang mga layunin maliban sa nabanggit.)
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RECORDS DIVISION
Client Information (Impormasyon ng Kliyente)
Name (optional)
Contact Details (optional); Pangalan (opsyonal)
Date Service Acquired (Petsa ng Pagkuha ng Serbisyo) *
MM
/
DD
/
YYYY
Service Acquired (Serbisyong Nakuha) *
*If Others, please specify
Client Satisfaction Rating
Kindly rate the quality of service provided by checking the appropriate box with 5 being the highest rating and 1 being the lowest. Select "N/A" if that Service Quality Dimension is not applicable for the service. ( 5 - Outstanding,  4 - Very Satisfied, 3 - Satisfied, 2 - Unsatisfied, 1 - Poor, N/A - Not Applicable )
Responsiveness (Pagtugon) *
Willingness to help, assist, and provide prompt service (Handang tumugon at magbigay nang mabilis na serbisyo sa kliyente)
5
4
3
2
1
N/A
Rating
Reliability (Maaasahan) *
Provision of what was needed and what was promised, in accordance with the policy and standards, with zero to a minimal error rate (Mahusay  na pagbibigay ng serbisyo ayon sa itinakdang pamantayan)
5
4
3
2
1
N/A
Rating
Access & Facilities (Lokasyon at Pasilidad) *
Convenience of location, ample amenities for a comfortable transaction, and the use of clear signages and modes of technology (Mabilis mapuntahan ang lugar at magamit ang pasilidad sa pamamagitan nang malinaw na karatula)
5
4
3
2
1
N/A
Rating
Communication (Pakikipag-usap) *
Act of keeping citizens and businesses informed in a language they can easily understand, as well as listening to their feedback (Pakikipag-ugnayan sa kliyente sa paraang malinaw at nauunawaan kasama ang mga opinion at puna)
5
4
3
2
1
N/A
Rating
Costs (Gastos) *
Satisfaction with the timeliness of the billing, billing process/es, preferred methods of payment period, value for money, acceptable range of costs, and qualitative information on the cost of each service (Kontento sa serbisyong natanggap at sa halagang naging katumbas o binayaran)
5
4
3
2
1
N/A
Rating
Integrity (Katapatan) *
Assurance that there is honesty, justice, fairness, and trust in each service while dealing with the clients and businesses (Pagtiyak sa serbisyong may  katapatan, hustisya, patas at tiwala sa habang nakikipig-ugnayan sa kliyente)
5
4
3
2
1
N/A
Rating
Assurance (Pagtitiwala) *
Capability of frontline staff/s to perform their duties, product and service knowledge, understanding client needs, helpfulness, and good work relationships (Kasiguruhan na gampanan ang tungkulin, na may kaalaman sa serbisyo, pag-unawa sa mga pangangailangan ng kliyente, matulungin, at maayos na ugnayan sa trabaho)
5
4
3
2
1
N/A
Rating
Outcome (Resulta ng Serbiyo) *
Rate in terms of achieving outcomes or realizing the intended benefits of the service (Markahan ang pangkalahatang serbisyo na natanggap)
5
4
3
2
1
N/A
Rating
Suggestions/Compliments/Comments *
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