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CSS Data Sheet

This document is a data sheet for collecting client feedback on government services. It includes sections for demographic information about clients, questions on the citizen's charter and service quality dimensions, and a section for free responses and client contact information. The goal is to get feedback from clients on their overall satisfaction and experience regarding access, responsiveness, reliability, facilities, communication, costs, integrity and outcome of the services provided.

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CA T He
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128 views

CSS Data Sheet

This document is a data sheet for collecting client feedback on government services. It includes sections for demographic information about clients, questions on the citizen's charter and service quality dimensions, and a section for free responses and client contact information. The goal is to get feedback from clients on their overall satisfaction and experience regarding access, responsiveness, reliability, facilities, communication, costs, integrity and outcome of the services provided.

Uploaded by

CA T He
Copyright
© © All Rights Reserved
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Document Code 

FM-SP-DILG-07-09
CSS Data Sheet  
Rev. No.  Eff. Date  Page 
00  02.01.23   of 1 1
Office: ___________________________________________________
Procedure Title/Service Provided:
Covered Period: _______________________________________________

DEMOGRAPHIC QUESTIONS CITIZEN'S CHARTER (CC) QUESTIONS SERVICE QUALITY DIMENSION (SQD) QUESTIONS CLIENT INFORMATION
DATE
DOCUMENT DATE CSS
NO. RELEASED/S FORM Overall Access & FREE RESPONSE
ERVICE RECEIVED Client Type Age Gender CC1 CC2 CC3 Satisfaction Responsiveness Reliability Facilities Communication Costs Integrity Assurance Outcome Name Email Address Contact Number
RENDERED (SQD0) (SQD1) (SQD2) (SQD3) (SQD4) (SQD5) (SQD6) (SQD7) (SQD8)

1
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nth

Prepared By  Noted By 


   

} Name Here { } Name Here {


:Date :Date
   
{ Position Title Here }  { Position Title Here } 

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