Privacy Notice: The personal information that will be gathered in this form will only be used for the purposes of administering the survey. This template is adopted from ARTA Memorandum Circular 2022-05 and DepEd Memorandum DM-PHROD-2021-0165. Rest assured your privacy will be protected. (Ang mga personal na impormasyong kukunin sa pormang ito ay gagamitin lamang para sa mga layuning kaugnay ng pagpapatupad ng survey. Ang template na ito ay hango sa ARTA Memorandum Circular 2022-05 at DepEd Memorandum DM-PHROD-2021-0165. Maaari pong tiyakin na ang inyong pagkapribado ay mahigpit na pangangalagaan.)

I. Client Information (Impormasyon ng Kliyente)
II. Client Satisfaction Rating
Kindly rate the quality of service provided by selecting the appropriate STAR. Leave star unselected if the criterion is not applicable for the service.
(Piliin ang STAR na nagsasaad ng iyong karanasan ukol sa serbisyong natanggap. Iwanang blanko ang pamantayan kung ito ay hindi angkop sa serbisyong natanggap.)

* 1. RESPONSIVENESS (PAGTUGON) Willingness to help, assist, and provide prompt service (Handang tumugon at magbigay nang mabilis na serbisyo sa kliyente):
* 2. RELIABILITY (MAAASAHAN) Provision of what was needed and what was promised, in accordance with the policy and standards, with zero to a minimal error rate (Mahusay na pagbibigay ng serbisyo ayon sa itinakdang pamantayan):
* 3. ACCESS & FACILITIES (LOKASYON AT PASILIDAD) Convenience of location, ample amenities for a comfortable transaction, and the use of clear signages and modes of technology (Mabilis mapuntahan ang lugar at magamit ang pasilidad sa pamamagitan nang malinaw na karatula):
* 4. COMMUNICATION (PAKIKIPAG-USAP) Act of keeping citizens and businesses informed in a language they can easily understand, as well as listening to their feedback (Pakikipag-ugnayan sa kliyente sa paraang malinaw at nauunawaan kasama ang mga opinion at puna):
5. COSTS (GASTOS) Satisfaction with the timeliness of the billing, billing process/es, preferred methods of payment period, value for money, acceptable range of costs, and qualitative information on the cost of each service (Kontento sa serbisyong natanggap at sa halagang naging katumbas o binayaran):
* 6. INTEGRITY (KATAPATAN) Capability of frontline staff/s to perform their duties, product and service knowledge, understanding client needs, helpfulness, and good work relationships (Kasiguruhan na gampanan ang tungkulin, na may kaalaman sa serbisyo, pag-unawa sa mga pangangailangan ng kliyente, matulungin, at maayos na ugnayan sa trabaho):
* 7. ASSURANCE (PAGTITIWALA) Assurance that there is honesty, justice, fairness, and trust in each service while dealing with the clients and businesses (Pagtiyak sa serbisyong may katapatan, hustisya, patas at tiwala sa habang nakikipig- ugnayan sa kliyente):
* 8. OUTCOME Rate in terms of achieving outcomes or realizing the intended benefits of the service (Markahan ang pangkalahatang serbisyo na natanggap):