Survey Questionnaire

Part I. Respondent Profile

Name (Optional)
Gender: Male Female

Instruction: Check ( ) the number that indicates your answer

Legend for Service Quality : Legend for Client’s Satisfaction

5 Strongly Agree 5 Highly Satisfied

4 Moderately Agree 4 Somewhat Satisfied
3 Neither Agree Nor Disagree 3 Neither Satisfied nor Dissatisfied
2 Moderate Disagree 2 Somewhat Dissatisfied
1 Strongly Disagree 1 Highly Dissatisfied

Part II. Service Quality

Responsiveness – willingness to help customers promptly 5 4 3 2 1

1. The staffs tell exactly when a service will be performed.

2. The staffs respond quickly when there is a problem.
3. The staffs provide prompt service.
4. The staffs attend customers immediately when they need
help.
5. The staffs are efficient to their job.

Assurance – trustworthiness of the service provider 5 4 3 2 1

1. The staffs refrain from pressuring the customers.
2. The staffs responses are given accurately and consistently
with other reliable source.
3. The staffs have a good constructive service.
4. The staffs perform accordingly to their tasks.
5. The staffs address customers appropriately.

Tangibles – physical appearance of facilities, equipments and 5 4 3 2 1

printed visual appearance.
1. Management uses technology in monitoring and
performing their service.
2. Management performs what they promise in their different
advertisement.
3. Management uses symbols that are easy to understand
4. Management maintains the cleanliness of their area
5. Store personnel are effective to their assigned tasks.
 Empathy – effort of knowing the customer needs. 5 4 3 2 1

1. The staffs show politeness and friendliness to their

customers.
2. The staffs have a pleasant personality.

3. The staffs observe consideration to the property of the

customers.
4. The staffs refrain from acting busy when the customer
asks a question
5. The staffs are flexible enough in accommodating
customers.

Reliability – ability to perform promise service. 5 4 3 2 1

1. The staffs perform service right the first time.

2. The staffs know what they are doing.
3. The staffs provide quality service all the time.
4. The staffs provide service without their subordinates.
5. The staffs are dependable when they are delivering their
service.

Part III. Clients Satisfaction

Clients’ Satisfaction 5 4 3 2 1

1. The staffs provide prompt service.

2. The staffs responses are given accurately and consistently

with other reliable source.
3. Management performs what they promise in their different
advertisement.
4. The staffs show politeness and friendliness to their
customers.
5. The staffs are dependable when they are delivering their
service.