CSM

CUSTOMER SATISFACTION MEASUREMENT

HELP US SERVE YOU BETTER!

This Customer 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 strictly confidential and you always have the option to not answer this form.

Email Address (optional)

Contact Number *

Region/Province *

Date Accomplished *

Age Group *

Services Availed *

Customer type *

Internal External ( Please specify by putting a checkmark on the appropriate customer type below)

Citizen Business Government (employee or another agency)

Sex *

Male Female Prefer not to indicate

INSTRUCTIONS: Checkmark (✔ ) 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. To know more about the Citizen's Charter of DOST VIII, you may click the Citizen's Charter logo above.

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.

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

2. Somewhat easy to see

3. Difficult to see

4. Not visible at all

5. N/A

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

2. Somewhat helped

3. Did not help

4. N/A

INSTRUCTIONS:
For SQD 0-8, please click the box to highlight the column that best corresponds to your answer.

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	N/A Not Applicable
SQD0. I am satisfied with the service that I availed.						N/A
SQD1. I spent a reasonable amount of time for my transaction.						N/A
SQD2. The office followed the transaction’s requirements and steps based on the information provided.						N/A
SQD3. The steps (including payment) I needed to do for my transaction were easy and simple.						N/A
SQD4. I easily found information about my transaction from the office or its website.						N/A
SQD5. I paid a reasonable amount of fees for my transaction. (If service was free, mark the ‘N/A’ column)						N/A
SQD6. I am confident my online transaction was secure.						N/A
SQD7. The office's online support was available, and (if asked questions) online support was quick to respond.						N/A
SQD8. I got what I needed from the government office, or (if denied) denial of request was sufficiently explained to me.						N/A

Note: If you gave a rating of Disagree and Strongly Disagree above, please specify your reason in the space provided below for us to know where we can improve.

Suggestions on how we can further improve our services (optional)

Your feedback will help us improve our services and serve you better! Thank you for your time!

Data Privacy Statement:
The Department of Science and Technology Regional Office VIII (DOST VIII) respects and protects the privacy of our data subjects (employees, clients, providers and other stakeholders) and ensure that all personal information collected are processed lawfully, fairly, and appropriately in accordance with the confidentiality practices and applicable laws on data privacy.