2023 Customer Satisfaction Survey Tool

Department of Environment ANTI-RED TAPE AUTHORITY
and Natural Resources CLIENT SATISFACTION MEASUREMENT

FORM
PSA Approval No: ARTA-2242-3
Expires on 31 July 2023
HELP US SERVE YOU BETTER!
This Client Satisfaction Measurement (CSM) tracks the customer experience of government offices. Your feedback on your recently
concluded transaction will help DENR provide a better service. Personal information shared will be kept confidential and you always
have the option to not answer this form. (Ang Client Satisfaction Measurement ay isang paraan upang subaybayan ng mga opisina ng
gobyerno ang karanasan sa serbisyo ng kanilang mga kliyente. Ang iyong papuri, puna o, suhestiyon sa iyong katatapos pa lamang na
transaksyon sa DENR ay makakatuling upang mapabuti pa ang serbisyo ng DENR. Ang iyong personal na impormasyon ay
sisiguraduhing pribado at mayroon kang opsyon na hindi sagutin ang form na ito.)
Client Profile
MM/DD/YYYY Type of Client (Uri ng kliyente)

Date of Application (Petsa ng aplikasyon)
Citizen/ Individual / Representative
(private citizen as transacting public)
Date of Release of Product/Services
(Petsa ng pagkakaloob ng produkto o serbisyo) Business/ Company
(representative of business/company firm)
Name (Pangalan) Organization/PO
(representative of an organization/People's
Organization)
Male Female
Sex (Kasarian) Age (Edad)
(Lalaki) (Babae) Government
(representative of other government agencies
including GOCCs)
Email address (Optional)
Service Availed
(Serbisyong natanggap)
INSTRUCTIONS: Check mark ( ) your answer to the Citizen's Charter (CC) questions. The Citizen's Charter is an official
document that reflects the services of a government agency/ office including its requirements, fees, and processing times
among others (PANUTO: Markahan ng ( ) ang iyong sagot sa mga tanong tungkol sa Citizen's Charter (CC). Ang Citizen's
Charter ay isang opisyal na dokumento na sumasalamin sa mga serbisyo ng isang ahensya/opisina ng gobyerno kasama ang
mga kinakailangang dokumento, bayad, at oras ng pagproseso nito bukod sa iba pa.)
Which of the following best describes your awareness of a Citizen's Charter? (Choose only one)
CC1 (Alin sa mga sumusunod ang makapaglalarawan ng iyong kaalaman tungkol sa Citizen's Charter? (Pumili lamang ng isa))
I know what a Citizen's Charter is and I saw this in this office.

1 (Mayroon akong kaalaman sa Citizen's Charter at nakita ko ito opisinang ito.)
I learned of the Citizen's Charter only when I saw this in this office.
2
(Ngayon ko lamang nalaman ang Citizen's Charter nang makita ko ito sa opisinang ito.)
I know what a Citizen's Charter is but I did NOT see it in this office.
3
(Mayroon akong kaalaman sa Citizen's Charter ngunit HINDI ko ito nakita sa opisinang ito.)
I do not know what a Citizen's Charter is and I did NOT see one in this office.
4 (Hindi ko alam ang Citizen's Charter at hindi ko ito nakita sa opisinang ito.)
Proceed only to CC2 and CC3 if your answer in CC1 is 1 or 2

(Sagutan lamang ang CC2 at CC3 kung ang iyong sagot sa CC1 ay 1 o 2.)
How would you describe the posting of the Citizen's Charter in this office? (Choose only one)
CC2 (Paano mo mailalarawan ang pagkakalagay o pagkakapaskil ng Citizen's Charter sa opisinang ito? (Pumili lamang ng isa))
Easy to see Difficult to see

(Madaling makita) (Mahirap makita)
Somewhat easy to see Not visible at all

(Medyo madaling makita) (Hindi talaga makita)
How helpful is the Citizen's Charter in your transaction? (Choose only one)
CC3 (Gaano nakatulong ang Citizen's Charter sa iyong transaksyon? (Pumili lamang ng isa))
Very Helpful Somewhat Helpful Not helpful

(Sobrang nakatulong) (Medyo nakatulong) (Hindi nakatulong)
INSTRUCTIONS:
Please indicate how strongly you agree or
disagree with all the STRONGLY DISAGREE NEITHER AGREE STRONGLY
following statements by checking or DISAGREE (HINDI AGREE NOR (SUMASANG AGREE
shading the corresponding circle from (LUBHANG HINDI SUMASANG DISAGREE AYON) (LUBHANG
SUMASANG- AYON) (HINDI TIYAK) SUMASANG
'strongly disagree' to 'strongly agree'.
AYON) AYON)
I spent a reasonable amount of time for my transaction.

(Naglaan ako ng resonableng oras para sa aking transaksyon)
The office followed the transaction's requirements and steps

based on the information provided.
(Ang opisina ay sumunod sa mga itinakdang pangangailangan
at hakbang para sa aking transaksyon .)
The steps (including payment) I needed to do for my

transaction were easy and simple.
(Ang mga hakbang (kasama ang pagbabayad) para sa
aking transakyon ay madali at simple.)
I easily found information about my transaction from the

office or its website.
(Madali kong nakita sa opisina o sa website ang mga
impormasyon na kinakailangan ko para sa aking transakyon.)
Answer only this statement if service/transaction availed has cost/fee

(Sagutan lamang ito kung ang kinuhang serbisyo ay may kaukulang bayad) Not Applicable
I paid a reasonable amount of fees for my transaction.

( Makatwiran ang ibinayad ko para sa aking transaksyon .)
I felt that the office was fair to everyone, or "walang palakasan",

during my transaction.
(Naramdaman kong naging patas sa lahat o "walang
palakasan"ang opisina sa panahon ng aking pakikipagtransaksyon)
I was treated courteously by the staff.

(Ako ay pinakitunguhan nang may paggalang ng mga kawani.)
I got what I needed from the office.

(Natanggap ko nang naaayon ang serbisyo o produktong
kinakailangan.)
I am satisfied with the service that I availed.

(Ako ay nasiyahan sa natanggap kong serbisyo.)
Suggestions/ Comments
To further improve our services, please provide any

suggestions, comments or concerns regarding the
service received. (Upang mas mapabuti pa ang aming
serbisyo, maaaring magbigay ng mungkahi, komento o
puna sa serbisyong natanggap.)
Data Privacy Consent By affixing my signature, I hereby consent DENR to collect, process, transmit and store the data provided
herein subject to the rules and regulations set by Republic Act No. 10173, otherwise known as the Data
Privacy Act of 2012.
for DENR authorized personnel only (Sa pamamagitan ng paglalagay ng aking lagda, pinahihintulutan ko ang DENR na kolektahin, iproseso,
ipadala at itago ang mga impormasyon na nakasaad sa papel na ito alinsunod sa Batas Republika Blg.
Control Number 10173 o ang Data Privacy Act of 2012.)
2023 DENR CSS Form Version 1 (January 2023)
Name and Signature (Pangalan at Lagda)
THANK YOU!

2023 Customer Satisfaction Survey Tool

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Department of Environment ANTI-RED TAPE AUTHORITY

and Natural Resources CLIENT SATISFACTION MEASUREMENT

MM/DD/YYYY Type of Client (Uri ng kliyente)

I know what a Citizen's Charter is and I saw this in this office.

Proceed only to CC2 and CC3 if your answer in CC1 is 1 or 2

Easy to see Difficult to see

Somewhat easy to see Not visible at all

Very Helpful Somewhat Helpful Not helpful

I spent a reasonable amount of time for my transaction.

The office followed the transaction's requirements and steps

The steps (including payment) I needed to do for my

I easily found information about my transaction from the

Answer only this statement if service/transaction availed has cost/fee

I paid a reasonable amount of fees for my transaction.

I felt that the office was fair to everyone, or "walang palakasan",

I was treated courteously by the staff.

I got what I needed from the office.

I am satisfied with the service that I availed.

To further improve our services, please provide any

2023 DENR CSS Form Version 1 (January 2023)

Name and Signature (Pangalan at Lagda)

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