ZCWD ARTA Survey Form

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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.

Date of Survey *

YYYY

Client Type *

Citizen

Business

Government (Employee or another agency)

Prefer not to say

Sex *

Male

Female

Prefer not to say

Age *

19 or lower

20 - 34

35 - 49

50 - 64

65 or higher

Prefer not to say

Email (optional)

Contact Number (optional)

Region of Residence *

Service Availed *

CITIZEN's CHARTER

INSTRUCTIONS: Choose 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? *

I know what a CC is and I saw this office's CC

I know what a CC is but I did NOT see this office's CC

I learned of the CC only when I saw this office's CC

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 in 1-3 in CC1), would you say that the CC of this office was...? *

Easy to see

Somewhat easy to see

Difficult to see

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? *

Helped very much

Somewhat helped

Did not help

N/A

SERVICE QUALITY DIMENSION

INSTRUCTIONS: for SQD 0-8, please indicate what best corresponds to your answer.

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

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly Agree

Not Applicable (N/A)

Your Answer:

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

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly Agree

Not Applicable (N/A)

Your Answer:

SQD2: The office followed the transaction's requirements and steps based on the information provided *

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly Agree

Not Applicable (N/A)

Your Answer:

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

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly Agree

Not Applicable (N/A)

Your Answer:

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

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly Agree

Not Applicable (N/A)

Your Answer:

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

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly Agree

Not Applicable (N/A)

Your Answer:

SQD6: I feel the office was fair to everyone, or "walang palakasan", during my transaction *

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly Agree

Not Applicable (N/A)

Your Answer:

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

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly Agree

Not Applicable (N/A)

Your Answer:

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

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly Agree

Not Applicable (N/A)

Your Answer:

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