7/25/2019 Feedback From
1/1
Department of Health
COMMISSION ON POPULATION
Welfareville Compound, Mandaluyong City
Date:___/___/___ Time:_______CLIENT FEEDBACK FORM
Name (optional):____________________________________________
Office/person to be visited:_______________________
Company: _______________________________ Contact
Number:______________________
Purpose of visit: ____ Inquire about the services ____ Scheduled
meeting/Appointment
____ Follow-up ____ Pick-up/Drop-off documents Others, pls
specify:_____________________________
Kindly evaluate the quality of service provided by the
Commission on Population. Please check the appropriate box which
best represents yourobservations.
WORK ENVIRONMENT YES NO WORK PERFORMANCE YES NO
1.
POPCOM premises are clean
2.
Office visited are clean andorderly
1. Duty guards are presentable, friendly and courteous.2.
Office watch/staff showed courtesy (e.g. greets and
introduces self)at the time of transaction3.
Office staff acted to my concern promptly and fast.4. Office
staff maintained professional conduct at all times.5.
My concerns were appropriately addressed by the office.
Overall, as a client, how satisfied areyou with the quality of
serviceprovided?
Very satisfied Satisfied Neither Dissatisfied Very
dissatisfied
Any comments or suggestions to
improve our services?
Department of Health
COMMISSION ON POPULATION
Welfareville Compound, Mandaluyong City
Date:___/___/___ Time:_______CLIENT FEEDBACK FORM
Name (optional):____________________________________________
Office/person to be visited:_______________________
Company: _______________________________ Contact
Number:______________________
Purpose of visit: ____ Inquire about the services ____ Scheduled
meeting/Appointment
____ Follow-up ____ Pick-up/Drop-off documents Others, pls
specify:_____________________________
Kindly evaluate the quality of service provided by the
Commission on Population. Please check the appropriate box which
best represents yourobservations.
WORK ENVIRONMENT YES NO WORK PERFORMANCE YES NO
1.
POPCOM premises are clean
2.
Office visited are clean andorderly
1. Duty guards are presentable, friendly and courteous.2.
Office watch/staff showed courtesy (e.g. greets andintroduces
self)at the time of transaction
3.
Office staff acted to my concern promptly and fast.4. Office
staff maintained professional conduct at all times.5.
My concerns were appropriately addressed by the office.
Overall, as a client, how satisfied areyou with the quality of
serviceprovided?
Very satisfied Satisfied Neither Dissatisfied Very
dissatisfied
Any comments or suggestions to
improve our services?
