7/8/22, 10:56 PM Convertible Emergency Shelters ready in Paniqui General Hospital Facility Shortage

Convertible Emergency Shelters

ready in
Paniqui
General Hospital Facility
Shortage
Dear Sir/Ma'am:

Greetings,

We the students of University of the Cordilleras Inc. Baguio City, As a fourth year student
taking up Bachelor of science in Architecture is currently tasked to conduct a research
study entitled: "Convertible Emergency Shelters
ready in Paniqui
General Hospital Facility Shortage" as part of requirement for the subject Research
Method for Architecture.

I humbly request your time for the survey to answer, 

which would only take approximately 3-5 minutes.

This survey aims to collect information relevant to the thesis proposal only. I assure you
the data gathered will not be available to anyone other than me to protect your privacy.

Rest assured that any information you provide will be kept confidential and used
exclusively for academic purposes.

Thank you very much for taking the time to respond positively to this request. Thank you,
and have a pleasant day.

Respectfully yours,

Bareng, King Philmill S.

BS Architecture Student 4
ksb022@students.uc-bcf.edu.ph
09667305364

1. Name:

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7/8/22, 10:56 PM Convertible Emergency Shelters ready in Paniqui General Hospital Facility Shortage

2. Age:

3. Gender:

Mark only one oval.

Male

Female

Prefer not to say

4. Respondent role

Mark only one oval.

Guardian

Patient

Became a patient in the hospital

Other:

5. Are you residing at Paniqui Tarlac?

Mark only one oval.

Yes

No

Other:

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7/8/22, 10:56 PM Convertible Emergency Shelters ready in Paniqui General Hospital Facility Shortage

6. If no, 
have you ever been to paniqui general hospital for treatment or check up?

Mark only one oval.

Yes

No

Other:

7. Based on your experience are you pleased with your accommodation in hospital?

Mark only one oval.

1 2 3 4 5

Unsatisfied Satisfied

8. Were all your needs met during your stay?

Mark only one oval.

Yes

No

Other:

9. If yes, do you think the hospital provided all your needs during your stay?

Mark only one oval.

Yes

No

Other:

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7/8/22, 10:56 PM Convertible Emergency Shelters ready in Paniqui General Hospital Facility Shortage

10. Do you think providing emergency shelters

could make any difference in the
accommodation of hospitals?

Mark only one oval.

Yes

No

11. If you were a patient would you use the

provided shelter if it’s the only available for
accommodation?

Mark only one oval.

Yes

No

12. Would you hesitate to use the provided shelters?

Mark only one oval.

Yes

No

13. If yes, what could be the possible factors that can affect your decision?

14. Have you ever experienced unaccommodated by the hospital because of room
shortage?

Mark only one oval.

Yes

No

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7/8/22, 10:56 PM Convertible Emergency Shelters ready in Paniqui General Hospital Facility Shortage

15. If yes, Does the hospital have other facility for accommodations or
recommendations?

Mark only one oval.

Yes

No

Other:

16. What would you suggest that should be provided in the said shelter?

17. Do you think it can solve the problem of facility shortage in hospital given the
current situation?

Mark only one oval.

Yes

No

Other:

18. How effective do you feel developing a convertible emergency shelters in paniqui
general hospital would bring a possible change?

Mark only one oval.

1 2 3 4 5

Not effective Very effective

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7/8/22, 10:56 PM Convertible Emergency Shelters ready in Paniqui General Hospital Facility Shortage

19. If you have any additional feedback you would like to share with me, regarding the
development emergency shelters in Paniqui General Hospital, please include here.

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 Forms

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