Name: (Optional) Age:

Gender: Occupational: (Optional)

Are you satisfied in Barangay Health Center?

.Questions Very Satisfied (4) Neutral (3) Unsatisfied 2) Very

Satisfied Unsatisfied (
(5)

1.How satisfied are

you with the quality
of care provided at
the Barangay Health
Center?
(Gaano ka
nasisiyahan sa
kalidad nang serbisyo
sa Barangay Health
Center?)
2. How would you
rate the cleanliness?
(Paano mo ire-rate
ang kalinisan sa
Barangay Health
Center?)
3. How would you
rate the availability of
medical supplies?
(Paano mo ire-rate
ang pagkakaroon ng
mga Medical
Supplies?)
4. How satisfied are
you with the wait
time to receive care?
(Gaano ka
nasisiyahan sa oras
nang paghihintay
para makatanggap
namg pangangalaga
mula sa Health
Center?)
5. How
knowledgeable and
helpful do you find
the staff? (Gaano
kaalam at
nakakatulong sa
tingin mo ang mga
 Name: (Optional) Age:
Gender: Occupational: (Optional)

Are you satisfied in Barangay Health Center?

staff?)
6. How do you feel
that the Health Center
provides adequate
privacy during
consultations?
7. How satisfied are
you with the
availability of
appointment times at
the Health Center?
8. How would you
rate the
communication and
explanation of
treatment options by
the Health Center
staff?
9. Are you satisfied
with the way the
Health Center
handles emergencies?
10. How satisfied are
you that the Health
Center easily
accessible and
convenient for you to
visit?
11. How would you
rate the competence
of the healthcare
providers?
12. How would you
rate the friendliness
of the staff?
13. How would you
rate the convenience
of the location of the
Brg. Health Center?
14. Are you satisfied
with the variety of
medical services
offered?
15. How likely are
 Name: (Optional) Age:
Gender: Occupational: (Optional)

Are you satisfied in Barangay Health Center?

you to recommend
the Brg. Health
center to friends and
family?
16. Health Center is
adequately sataffed to
meet the needs of the
community. (Rate)
17. How would you
rate the
responsiveness of the
staff?
18.

19.

20. How would you

rate the overall
experience of visiting
Brg. Health Center?