ANTI-RED TAPE AUTHORITY
Republic of the Philippines CLIENT SATISFACTION
MEASUREMENT FORM
SCHOOL DEPARTMENT OF EDUCATION PSA Approval No.: ARTA-2242-3
Expires on 31 July 2023
LOGO Region VI – Western Visayas
Schools Division of Cadiz City
SCHOOL NAME
Control No.: __________
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
service. Personal information shared will be kept confidential and you always have the option to
not answer this form.
Date: ______________ Client type: Citizen Business Government (Employee or
another agency)
Sex: Male Female Age: _______ Region of residence:
___________________________
Service Availed:
External Services: Acceptance of employment Application for Teacher I Position (Walk-
in)
Acceptance of employment Application for Teacher I Position (Online)
Borrowing of Learning Materials from the School Library/Learning Resource
Center
Distribution of Printed Self-Learning Modules in Distance Learning Modality
Enrollment (Walk-in)
Enrollment (Online)
Issuance of Requested Documents in Certified True Copy (CTC) and
Photocopy (Walk-in)
Issuance of Requested Documents in Certified True Copy (CTC) and
Photocopy (Online)
Issuance of School clearance for different purposes
Issuance of School Forms, and other School Permanent Records
Public assistance (walk-in/phone call)
Public assistance (email/social media)
Receiving and releasing of communications and other documents
Reservation Process for the use of School Facilities
Request for Personnel Records for Teaching/Non-Teaching Personnel
Internal Services: Issuance of Special Order for Service Credits and Compensatory Time
Credits
Laboratory and School Inventory
School Learning and Development
Other Services (please specify):
__________________________________________________________________________________________________
______________________________________________________________________________
Person transacted to: _________________________________________
INSTRUCTIONS: Check mark (✔ ) 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?
1. I know what a CC is and I saw this office’s CC.
2. I know what a CC is but I did NOT see this office’s CC.
3. I learned of the CC only when I saw this office’s CC.
ANTI-RED TAPE AUTHORITY
Republic of the Philippines CLIENT SATISFACTION
MEASUREMENT FORM
SCHOOL DEPARTMENT OF EDUCATION PSA Approval No.: ARTA-2242-3
Expires on 31 July 2023
LOGO Region VI – Western Visayas
Schools Division of Cadiz City
SCHOOL NAME
Control No.: __________
4. 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 1-3 in CC1), would you say that the CC of this office
was …?
1. Easy to see 4. Not visible at all
2. Somewhat easy to see 5. N/A
3. Difficult to see
CC3 If aware of CC (answered codes 1-3 in CC1), how much did the CC help you in
your transaction?
1. Helped very much 3. Did not help
2. Somewhat helped 4. N/A
INSTRUCTIONS:
For SQD 0-8, please put a check mark (✔ ) on the column that best corresponds to your answer.
N/A
Strongly Disagree Neither Agree Strongly Not
Disagree Agree Agree Applicab
nor le
Disagree
SQD0. I am satisfied with the
service that I availed.
SQD1. I spent a reasonable amount
of time for my transaction.
SQD2. The office followed the
transaction’s requirements and
steps based on the information
provided.
SQD3. The steps (including
payment) I needed to do for my
transaction were easy and simple.
SQD4. I easily found information
about my transaction from the
office or its website.
SQD5. I paid a reasonable amount
of fees for my transaction.
SQD6. I feel the office was fair to
everyone, or “walang palakasan”,
during my transaction.
SQD7. I was treated courteously by
the staff, and (if asked for help) the
staff was helpful.
SQD8. I got what I needed from the
government office, or (if denied)
denial of request was sufficiently
ANTI-RED TAPE AUTHORITY
Republic of the Philippines CLIENT SATISFACTION
MEASUREMENT FORM
SCHOOL DEPARTMENT OF EDUCATION PSA Approval No.: ARTA-2242-3
Expires on 31 July 2023
LOGO Region VI – Western Visayas
Schools Division of Cadiz City
SCHOOL NAME
Control No.: __________
explained to me.
Suggestions on how we can further improve our services (optional):
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Email address (optional): __________________________________
THANK YOU!
