Republic of the Philippines Republic of the Philippines

Department of Education Department of Education

REGION XI REGION XI
MIPANGI ELEMENTARY SCHOOL MIPANGI ELEMENTARY SCHOOL

CLIENT FEEDBACK SURVEY FORM CLIENT FEEDBACK SURVEY FORM

(Your feedback matters. Please help us serve better by taking a few minutes to tell us about (Your feedback matters. Please help us serve better by taking a few minutes to tell us about
the service you received today.) the service you received today.)

Date: ________________________________________________ Date: ________________________________________________

Name (Optional): ______________________________________ Name (Optional): ______________________________________
Agency/School affiliated: ________________________________ Agency/School affiliated: ________________________________
Purpose of Transaction: _________________________________ Purpose of Transaction: _________________________________
Office Transacted With (Please mark check to the box provided.) Office Transacted With (Please mark check to the box provided.)
Office of the School Head Library/ LRMDC Office of the School Head Library/ LRMDC
Classroom Supply Office Classroom Supply Office
Planning and Records Office Clinic Planning and Records Office Clinic

Customer Satisfaction Rating (Please use the rating scale below.) Customer Satisfaction Rating (Please use the rating scale below.)
1 – POOR 3 – SATISFACTORY 1 – POOR 3 – SATISFACTORY
2 – NEEDS IMPROVEMENT 4 – EXCELLENT 2 – NEEDS IMPROVEMENT 4 – EXCELLENT
1 2 3 4 1 2 3 4
1. The staff is/are courteous and helpful. 1. The staff is/are courteous and helpful.
(Ang mga kawani ay magalang at matulungin.) (Ang mga kawani ay magalang at matulungin.)
2. I was given an immediate response to my queries. 2. I was given an immediate response to my queries.
(Nabigyan kaagad ako ng kaukulang tugon sa (Nabigyan kaagad ako ng kaukulang tugon sa
aking mga tanong.) aking mga tanong.)
3. the process flow is easy and not time consuming. 3. the process flow is easy and not time consuming.
(Madali at klaro ang pagproseso ng mga dokumento.) (Madali at klaro ang pagproseso ng mga dokumento.)
4. I was able to finish my transaction/s based on my 4. I was able to finish my transaction/s based on my
timeline. timeline.
(Natapos ko agad ang aking mga transaksyon ayon sa (Natapos ko agad ang aking mga transaksyon ayon sa
itinakdang oras.) itinakdang oras.)
5. My overall experience today is… 5. My overall experience today is…
(Ang pangkalahatang karanasan ko sa araw na ito ay…) (Ang pangkalahatang karanasan ko sa araw na ito ay…)

Customer Feedback: Please write any comment/ suggestion/ complaints: Customer Feedback: Please write any comment/ suggestion/ complaints:
_________________________________________________________________ _________________________________________________________________
_________________________________________________________________. _________________________________________________________________.
Thank you for your time, We are happy to serve you. Thank you for your time, We are happy to serve you.

Republic of the Philippines Republic of the Philippines

Department of Education Department of Education
REGION XI REGION XI
MIPANGI ELEMENTARY SCHOOL MIPANGI ELEMENTARY SCHOOL

CLIENT FEEDBACK SURVEY FORM CLIENT FEEDBACK SURVEY FORM

(Your feedback matters. Please help us serve better by taking a few minutes to tell us about (Your feedback matters. Please help us serve better by taking a few minutes to tell us about
the service you received today.) the service you received today.)

Date: ________________________________________________ Date: ________________________________________________

Name (Optional): ______________________________________ Name (Optional): ______________________________________
Agency/School affiliated: ________________________________ Agency/School affiliated: ________________________________
Purpose of Transaction: _________________________________ Purpose of Transaction: _________________________________
Office Transacted With (Please mark check to the box provided.) Office Transacted With (Please mark check to the box provided.)
Office of the School Head Library/ LRMDC Office of the School Head Library/ LRMDC
Classroom Supply Office Classroom Supply Office
Planning and Records Office Clinic Planning and Records Office Clinic

Customer Satisfaction Rating (Please use the rating scale below.) Customer Satisfaction Rating (Please use the rating scale below.)
1 – POOR 3 – SATISFACTORY 1 – POOR 3 – SATISFACTORY
2 – NEEDS IMPROVEMENT 4 – EXCELLENT 2 – NEEDS IMPROVEMENT 4 – EXCELLENT
1 2 3 4 1 2 3 4
1. The staff is/are courteous and helpful. 1. The staff is/are courteous and helpful.
(Ang mga kawani ay magalang at matulungin.) (Ang mga kawani ay magalang at matulungin.)
2. I was given an immediate response to my queries. 2. I was given an immediate response to my queries.
(Nabigyan kaagad ako ng kaukulang tugon sa (Nabigyan kaagad ako ng kaukulang tugon sa
aking mga tanong.) aking mga tanong.)
3. the process flow is easy and not time consuming. 3. the process flow is easy and not time consuming.
(Madali at klaro ang pagproseso ng mga dokumento.) (Madali at klaro ang pagproseso ng mga dokumento.)
4. I was able to finish my transaction/s based on my 4. I was able to finish my transaction/s based on my
timeline. timeline.
(Natapos ko agad ang aking mga transaksyon ayon sa (Natapos ko agad ang aking mga transaksyon ayon sa
itinakdang oras.) itinakdang oras.)
5. My overall experience today is… 5. My overall experience today is…
(Ang pangkalahatang karanasan ko sa araw na ito ay…) (Ang pangkalahatang karanasan ko sa araw na ito ay…)

Customer Feedback: Please write any comment/ suggestion/ complaints: Customer Feedback: Please write any comment/ suggestion/ complaints:
_________________________________________________________________ _________________________________________________________________
_________________________________________________________________. _________________________________________________________________.
Thank you for your time, We are happy to serve you. Thank you for your time, We are happy to serve you.