Magandang Araw!

(Good Day!)

Isa itong uri ng pagtatanong o pagsisiyasat upang lalong mapaigting,

mapaganda at maging angkop ang serbisyo ng PNP-WCPC sa mga katulad ninyong
nangangailangan ng tugon sa inyong reklamo. Ito ay kumpidensyal at hindi puedeng
ibahagi sa iba. (This is a survey to make PNP-WCPC better and more appropriate for
those with similar needs in response to your complaint. It is confidential and cannot be
shared with others.)

I. Pagkakakilanlan (Personal Identification):

Buong Pangalan (Opsyonal) _____________________________________________

(Full Name (Optional)
Lugar kung saan ginanap ang pagsisiyasat o survey ________________________
(Place where the survey was conducted)
Kasarian (Gender)_____________________ Edad (Age)________________________

Lugar ng Tinitirhan (Address): ____________________________________________

______________________________________________________________________

Paki-Tsek ang naaayong sagot. (Please check ( ) the appropriate answer)

Estadong Sibil (Civil Status) Antas ng Napag-Aralan (Educational Attainment

____ Walang Asawa (Single)
____ May Asawa (Married)
____ Hiwalay sa Asawa (Separated)
____ Biyuda/Byudo (Widow/er)
____ May Kinakasama (Live-in Partner)
____ Elementarya (Elementary)
____ Hayskul (High School)
____ Bokasyonal (Vocational)
____ Kolehiyo (College)
____ Graduate Studies

Hanapbuhay (Occupation)
____ Estudyante (Student) ____ Kasambahay
____ Maybahay (Housewife) ____ May Sariling Negosyo
____ OFW ____ Consultant
____ Pribadong Empleyado (Private Employee) ____ Walang Trabaho
____ Empleyado ng Gobyerno (Government Employee) ____ Iba pa (Others)____________

Ano ang pangalan ng Social Worker o Pulis na tumulong at tumogon sa inyong

reklamo? (What is the name of the Social Worker or Police Officer who attended and
addressed your complaint?)

____________________________________________________________________________
II. Pagkilala sa serbisyo.

Kumusta ang serbisyo ng PNP-WCPC? Maari lamang na bigyan sila ng iskor ayon
sa sumusunod:(How do the PNP-WCPC services delivered? Give them a score
according to the following:)

4- Talagang Sumasang-Ayon (Strongly Agree)

3- Sumasang-Ayon (Agree)
2- Hindi Sumasang- Ayon (Disagree)
1- Talagang Hindi Sumasang-Ayon (Strongly Disagree)

_____ 1. Maayos ang pagtrato at pakikitungo sa akin, at hindi ako hinuhusgahan ayon sa aking
pang labas na kaanyuan o estado sa buhay. Kung hindi naman, bakit hindi? (They are all polite
and pleasant in accommodating me without any discrimination in my personal being. If not so,
why not?)

_____ 2. Binibigyan ako ng pagkakataon na maging mahinahon upang maayos kong mailahad
ang aking reklamo. Kung hindi naman, bakit hindi? (He/She gives me the opportunity to be
calm and patient so I can best handle my complaint.)

______3. Tiwala akong magbigay ng aking sinumpaang salaysay sa imbestigador/kinatawan ng

PNP-WCPC tungkol sa naranasan kong pang-aabuso. Kung hindi naman, bakit hindi? (I am
confident to give my sworn affirmation to the investigator / PNP-WCPC representative about my
experience of abuse).

_____ 4. Ipinaliwanag sa akin nang maayos at lubusan kung paano isasampa ang kaso at kung
ano-ano ang mga proseso kaugnay nito. Kung hindi naman, bakit hindi? (They explained to
me properly and thoroughly how to file the case and what processes are related to it.)

_____ 5. Naipabatid din sa akin ang mga hakbang at mga bagay-bagay na dapat kong gawin
para sa agarang kalutasan ng aking kaso. Kung hindi naman, bakit hindi? (All the steps and
the things I should do for the immediate resolution of my case were discussed.)

_____ 6. Naniniwala ako na tutulungan ako ng mga imbestigador/kinatawan ng PNP-WCPC

upang matapos at mapagtagumpayan ko anuman ang resulta ng aking isinampang kaso.
Kung hindi naman, bakit hindi? (I believe that PNP-WCPC investigators / representatives will
help me to finish and overcome whatever the result of my case.)

Mayroon ka bang komento o reklamo laban sa PNP-WCPC, o kaya’y suhestyon kung

paano mas mapapabuti ang aming serbisyo? (Do you have any comment or complaint against
the PNP-WCPC, or suggestions on how we can improve our services?)

____________________________________________________________________________
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Maraming Salamat Po!

(Thank you very much!)