Republic of the Philippines

Department of Education
Region VI –Western Visayas
SCHOOLS DIVISION OF ILOILO CITY
(Please use your school heading)

CLIENT FEEDBACK FORM CONTENTS OF THIS

FORM ARE HIGHLY
NAME (O _______________________________________________ CONFIDENTIAL
EMAIL/CONTACT NO. (Optional) ___________________________________
DATE OF TRANSACTION: _________________________ Time:___________
OFFICE TRANSACTED/VISITED:
Office of the Principal Administrative Office
Library Supply
Enrolment/Admission Cashier
Public Affairs Personnel (HR)
Laboratory and School Inventory Records
Learning and Development Canteen
Finance Services Clinic
DRRM Guidance
ICT PTA
LRMS Others: Please Specify ____________
Planning

Please let us know how well we met your expectations and what we could do to improve our services to you and
future clients/visitors to our office.

Thank you for your assistance.

Tick (√) the box of the appropriate description of your experience on your recent visit to us.

How would you rate the:

 physical appearance/tone of the voice/behavior/action/manner shown by the employee/staff?

(5) Most satisfied (4) Very satisfied (3) Satisfied (2) Less satisfied (1) Least satisfied

 promptness and soundness of the services/assistance provided to you?

(5) Most satisfied (4) Very satisfied (3) Satisfied (2) Less satisfied (1) Least satisfied

 cleanliness and atmosphere of the office?

(5) Most satisfied (4) Very satisfied (3) Satisfied (2) Less satisfied (1) Least satisfied

 cleanliness of the comfort room or wash room? (in case you used this room)
(5) Most satisfied (4) Very satisfied (3) Satisfied (2) Less satisfied (1) Least satisfied

 provision of alcohol and sanitizers in the office?

(5) Most satisfied (4) Very satisfied (3) Satisfied (2) Less satisfied (1) Least satisfied

 overall impression you have for the school?

(5) Most satisfied (4) Very satisfied (3) Satisfied (2) Less satisfied (1) Least satisfied

Feel free to leave additional comments, suggestions and impressions.

_______________________________________________________________________

_______________________________________________________________________

Address: Gen. Luna – Mabini Sts., Iloilo City

Telephone Nos.: (033) 336 9273 / (033) 3336 4745
Website: http://depediloilocity.net
 Republic of the Philippines
Department of Education
Region VI –Western Visayas
SCHOOLS DIVISION OF ILOILO CITY

Address: Gen. Luna – Mabini Sts., Iloilo City

Telephone Nos.: (033) 336 9273 / (033) 3336 4745
Website: http://depediloilocity.net