Department of Education

Schools Division of Tarlac

STA. ROSA NATIONAL HIGH SCHOOL

CLIENT’S SATISFACTION SURVEY

We, in SRNHS, would like to improve the delivery of our services based on your feedback.

Please fill-out this Feedback Form and submit it to our Officer-In-Charge. Rest assured your responses
will be dealt with confidentiality under Data Privacy Act R.A. No. 10173

Overall Rating

__Oustanding (O) ___Very Satisfied(VS) ___ Satisfied(S) __Dissatisfied(D) ___Very Dissatisfied(VD)

In answering, please check the appropriate space of your choice, whenever applicable. (Palihug isulat ang
Tsek tungod sa inyong napiling tubag sa matag pangutana.)

O VS S D VD o Quality of Service Kalidad sa Proseso sa Serbisyo (5) (4 (3) (2) (1)

a. PROSESO
o Organized and Easy to follow ___ ___ ___ ___ ___ (Organisado ug sayon masabtan ang
proseso)
o Client’s comfort is given utmost concern ___ ___ ___ ___ ___ (Gitagaan ug dakong
pagtagad ang panginahanglan ug tuyo sa mga ginikanan )

o Client’s concerns were addressed promptly ___ ___ ___ ___ ___ (Matapos sa igung
panahon ang pagproseso sa pag-aksyon sa panginahanglan.)

b. PERSONNEL/
o Courtesy ___ ___ ___ ___ ___ (Matinahuron sa pagtubag sa mga pangutana.)
o Responsiveness and ___ ___ ___ ___ ___ (Ana-a andam mo serbisyo ug sayon /dali
makontak)
o Competence ___ ___ ___ ___ ___ (Adunay igong kahibalo sa pag-aksyon sa mga
panginahanglan)
o Accuracy and Adequacy information given ___ ___ ___ ___ ___ (Sakto ug igo ang
impormasyong)

Personal and Other Information EXTERNAL CLIENT

Date: _____________________________
Name: (Optional)_______________________________
Purpose of Transaction: ______________________________________
Office Transacted with.: _____________________ Gender:
_____________________
Please suggest ways by which we can improve our process and on how our personnel attend to your
needs. Mahimong muhatag sa inyong sugyot, komentaryo , rekomendasyon o reklamo alang sa
pagpalambo sa among proseso ug kalidad sa serbisyo sa matag tagdumala.
______________________________________________________________________________
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 SCHOOL ACTIVITY FEEDBACK FORM
Name (optional):
_______________________________________________ Activity
Organizer: _____________________________________________

Title of the Activity: _____________________________________________

______________________________________________________________

Date: ____________________________Venue: ________________________

Instruction: Encircle the number that corresponds to your rating of the activity conducted.
Criteria Ratings

Stron Agree Disagree Stron

gly gly
Agree Disagr
ee

4 3 2 1

1. The activity started and ended 4 3 2 1

on time. (Ang kalihukan
nagsugod ug
natapos sa hustong oras.)

2. Meets activity’s purpose. Nakab- 4 3 2 1

ut ang katuyuan sa maung kalihukan

3. Events and activities were in 4 3 2 1

sequence. ( Sakto ang pagkahan-ay
sa mga panghitabu.)

4. Venue and ventilation were taken 4 3 2 1

into consideration. ( Plastado ug hapsay
ang lugar-gidumalahan)

5. Participants followed the set rules 4 3 2 1

and regulations. ( Nagasunod sa
patakaran ug pahimangyu)

6. Purposes were communicated 4 3 2 1

clearly( maayu ug tin-aw ang
pakigpulong)

7. Fulfillment of the assigned tasks 4 3 2 1

( Nakab-ut ang angay buhatun)

8. Maintained participants interest 4 3 2 1

( Malahutayung pakiglambigit)

9. Well Prepared ( Maayong ang 4 3 2 1

pagkaandam)

MEETING FEEDBACK: Please write your comments, suggestions, recommendations about the conduct of
the meeting.
 SCHOOL MEETNG FEEDBACK FORM

Name (optional):
_______________________________________________ Activity
Organizer: ______________________________________________ Title of
the Activity: _____________________________________________
_____________________________________________________________
_ Date: ____________________________Venue:
________________________

Instruction: Encircle the number that corresponds to your rating of the activity conducted.

Criteria Ratings Strongly

Agree Disagree Strongly
Agree
Disagree
4321
A. The meeting was well-planned
1. Members were notified/ informed in
4321
advance.
2. There was a pre-arranged agenda. 4 3 2 1 B. The meeting was properly
organized
1. The meeting started and ended on t
4321
ime
2. The meeting observed proper
4321
parliamentary procedure.
3. Discussion and deliberation of the
4321
agenda were clearly presented.
4. All concerns, clarifications and
4321
questions were all attended to.
5. The meeting was properly
4321
documented.

MEETING FEEDBACK: Please write your comments, suggestions, recommendations about the
conduct of the meeting.
 STAKEHOLDER’S MEETING FEEDBACK FORM
_________________

Name (optional):
_______________________________________________ Activity
Organizer: ______________________________________________ Title of
the Activity: _____________________________________________
_____________________________________________________________
_ Date: ____________________________Venue:
________________________

Instruction: Encircle the number that corresponds to your rating of the activity conducted.

Criteria Ratings Strongly

Agree Disagree Strongly
Agree
Disagree
4321
A. The meeting was well-planned
1. Members were notified/ informed in
4321
advance.
2. There was a pre-arranged agenda. 4 3 2 1 B. The meeting was properly
organized
1. The meeting started and ended on
4321
Time.
2. The meeting observed proper
4321
parliamentary procedure.
3. Discussion and deliberation of the
4321
agenda were clearly presented.
4. All concerns, clarifications and
4321
questions were all attended to.
5. The meeting was properly
4321
documented.