CLIENT SATISFACTION SURVEY FORM
Name of Client
Date
*
Organization
*
Government Agency
Private Institution
Non-Gov’t. Org.
Others:
Others:
Client Type
*
Local
International
Client Description
*
Teaching
Student
Non-Teaching
Alumni
Others:
Others:
*
Service/s Availed
*
Facilitation of Visit
Request for Travel Clearance
Mobility Application
Others:
Facilitation of Visit
*
Exploratory/Establish Linkage
Fulfillment of MOU/MOA Agreement
Follow-up visit
Staff Teaching/Training Mobility
Student Exchange/Mobility
Volunteer
Visiting Scientist/Researcher
Visiting Professor
Project Implementation
Others:
*
Please tell us your level of agreement with the statements below based on the service/s provided by the office using the evaluation criteria below. Kindly check the box corresponding to your choice.
5 – Strongly Agree 4 – Agree 3 – Neutral 2 – Disagree 1 – Strongly Disagree
1. The service/s I need was/were provided within the timeline set by the office.
5
4
3
2
1
2. The personnel/s provided me with accurate information and/or data.
5
4
3
2
1
3. The appropriate service I need was provided completely.
5
4
3
2
1
4. The attending personnel/s used a language or dialect that I can easily understand.
5
4
3
2
1
5. The attending personnel/s was/were courteous, respectful, and accommodating.
5
4
3
2
1
6. The attending personnel/s knew exactly what s/he/they are/are doing.
5
4
3
2
1
7. Escort, transportation, and accommodation were adequately provided.
5
4
3
2
1
Overall Satisfaction Rating
*
😃 – Very satisfied
😌 – Satisfied
😐 – Neutral
🙁 – Dissatisfied
😫 – Very Unsatisfied
Remarks
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