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CLIENT FEEDBACK FORM

HELP US SERVE YOU BETTER!


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 experience. Personal information shared will be kept confidential and you always have the option to not answer this form.

Client Type *
Sex *
Age *
Date *
Region of Residence *
Service Availed *
Contact Number *

INSTRUCTION: Please select your response 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? *
CC2. If aware of CC (answered in 1-3 in CC1), would you say that the CC of this office was? *
CC3. If aware of CC (answered in 1-3 in CC1), how much did the CC help you in your transaction? *
INSTRUCTION: Please choose the column for the Service Quality Dimensions (SQD) 0 - 8 that most closely matches your response.

We value your opinion. In this regard, may we know the name/s of personnel who you consider as having rendered commendable service/s?
Suggestion on how we can further improve our services:
Email address (Optional):

Anti-Red Tape Authority (ARTA). Client Satisfaction Measurement (CSM) Prescribed Form

THANK YOU

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