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Satisfaction Survey
Satisfaction Survey | SIPORA
Service Review and Satisfaction Form
Responden
Sebelum Anda mulai mengisi survei, mohon isikan data diri Anda untuk memungkinkan kami menyajikan informasi yang lebih personal dan relevan sesuai dengan pengalaman Anda.
Gender
Male
Female
Please select your gender.
Education
None
Elementary School
Junior High School
Senior High School
Vocational School
Diploma 1 (D1)
Diploma 2 (D2)
Diploma 3 (D3)
Diploma 4 (D4)
Bachelor (S1)
Applied Bachelor (S1 Applied)
Master (S2)
Doctorate (S3)
Please include your highest education level.
Marital Status
Married
Single
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Divorced
Marital status must be filled in or cannot be empty.
Occupation
Civil Servant
Military/Police
Entrepreneur
Student
Other
Please include your current occupation.
Date of Birth
Date of birth must be filled in or cannot be empty.
Services Received
Athlete Coaching Service
Recreational Sports Service
Facility Usage Service
Youth and Other Sports Service
Select the services you have used.
Respondent Opinions about public services
Dear Sir/Madam/Dear
Kami menjamin
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Sir/Madam/Dear in filling out this questionnaire.
To fill it out, simply check one of the answer choices.
For your availability, we thank you.
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Question
Choose Answer
1.
Bagaimana pendapat Saudara tentang kesesuaian persyaratan pelayanan dengan jenis pelayanannya ?
Please complete the questionnaire answers first.
Tidak Sesuai
Kurang Sesuai
Sesuai
Sangat Sesuai
2.
Bagaimana pemahaman Saudara tentang kemudahan prosedur pelayanan di unit ini ?
Please complete the questionnaire answers first.
Tidak mudah
Kurang mudah
Mudah
Sangat mudah
3.
Bagaimana pendapat Saudara tentang kecepatan waktu dalam memberikan pelayanan ?
Please complete the questionnaire answers first.
Tidak cepat
Kurang cepat
Cepat
Sangat cepat
4.
Bagaimana pendapat Saudara tentang kewajaran biaya/tarif dalam pelayanan ?
Please complete the questionnaire answers first.
Sangat mahal
Cukup mahal
Murah
Gratis
5.
Bagaimana pendapat Saudara tentang kesesuaian produk pelayanan antara yang tercantum dalam standar pelayanan dengan hasil yang diberikan ?
Please complete the questionnaire answers first.
Tidak sesuai
Kurang sesuai
Sesuai
Sangat sesuai
6.
Bagaimana pendapat Saudara tentang kompetensi/kemampuan petugas dalam pelayanan ?
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Tidak sesuai
Kurang sesuai
Sesuai
Sangat sesuai
7.
Bagaimana pendapat Saudara perilaku dalam pelayanan terkait kesopanan dan keramahan ?
Please complete the questionnaire answers first.
Tidak sopan dan ramah
Kurang sopan dan ramah
Sopan dan rama.
Sangat sopan dan ramah
8.
Bagaimana pendapat Saudara tentang penanganan pengaduan pengguna layanan ?
Please complete the questionnaire answers first.
Tidak ada
Ada tetapi tidak berfungsi
Berfungsi kurang maksimal
Dikelola dengan baik
9.
Bagaimana pendapat Saudara tentang kualitas sarana dan prasarana ?
Please complete the questionnaire answers first.
Tidak baik
Kurang baik
Baik
Sangat baik
Please make sure all answers are filled in, and respondent data information is correct.