June 1, 2023

_____________________
_____________________
Sir/ Ma’am,

Greetings of Peace!

The undersigned is a graduate student at the Eastern Samar State University. As a

requirement of the degree, I am conducting my master’s thesis entitled “Profile of the
Barangay Health Emergency Response Team and the Clients’ Satisfaction of their
Services”.
.
This research study aims This study aims to assess the implementation of BHERTs services
in the municipality of Can-avid, Eastern Samar. It aims to determine largely the capability of
the BHERT to handle emergency responses within their barangay. By understanding the
capabilities and performance of BHERT, policymakers and stakeholders can identify areas
for improvement and develop strategies to strengthen BHERT's capacity to respond to
health emergencies and disasters. All the information you will provide in any document
related to the study that requires personal information (e.g., name and signature in this
consent form) will be treated with utmost diligence and confidentiality. Moreover, all the
information you provided will be used exclusively for recording, general reporting, and
achieving the study's objectives only. No part of your provided information shall be
reproduced or exhibited without your written consent. If you agree to the term and participate
in the study, you will be asked to complete the survey/questionnaire.

By agreeing, you are indicating that you are at least 18 years old, have read and understood
this consent form and agree to participate in this research study.

o I agree

o I disagree

________________________________ __________________
Name and Signature Date

Sincerely,

JOEL C. QUIRANTE
Researcher
Directions: Please supply all the information needed by writing the space provided. There
are no right or wrong answers, your answers will be kept strictly confidential and you will not
be identified.

A. This instrument is intended to assess the level of satisfaction on the BHERTs

services as perceived by the clients

You will see listed below a range of skilled activities and services that you may have
availed. Look at each of these activities and then rate each one by writing the
appropriate number in the box.

Level of Satisfaction
5 - Highly Satisfied
4 - Satisfied
3 - Neutral
2 - Unsatisfied
1 - Highly unsatisfied

INDICATORS Level of Satisfaction

5 4 3 2 1
I. Level of Satisfaction in response to Basic Life Support
1. I am satisfied with the basic life support services of BHERT in performing
Cardiopulmonary Resuscitation to:
a. Adult
b. Child
c. Infant
2. I am satisfied with the basic life support services of BHERT in performing Rescue
breathing to an/a:
a. Adult
b. Child
c. Infant
3. I am satisfied with the basic life support services of BHERT in performing airway
obstruction management to an/a:
a. Adult
b. Child
c. Infant
4. I am satisfied with the basic life support services of
BHERT in ensuring the proper ways of ventilation in
the center
5. I am satisfied with the basic life support services of
BHERT in performing compression-only CPR
II. Level of Satisfaction in response relative to Standard First Aid
1. I am satisfied with the BHERTs roles and
responsibilities as the first aider
2. I am satisfied with the programs of BHERTs in terms
of the process of transmission of disease
3. I am satisfied with the BHERTs services on wounded
clients
4. I am satisfied with the BHERTs services on fractured
clients
5. I am satisfied with the BHERTs services on clients
with burning incidents
 III. Level of Satisfaction to respond to emergency situation
1. I am satisfied with how the BHERTs analyze the
incident situation
2. I am satisfied with how the BHERTs are aware of
handling confidential information
3. I am satisfied with how the BHERTs are
knowledgeable in using different tools and equipment
4. I am satisfied with the BHERTs’ proper documentation
5. I am satisfied with how knowledgeable the BHERTs in
the maintenance of different tools and equipment
IV. Level of Satisfaction in ensuring community health awareness and program
implementation
1. I am satisfied with the services of BHERTs in
disseminating LGU or DOH health advisories and
programs to the community
2. I am satisfied with the services of BHERTs in the
implementation and conduct of government-
prescribed community health activities and programs
for our constituents
3. I am satisfied with the services of BHERTs in their
conduct of health advising or counseling to our
constituents
4. I am satisfied with the services of BHERTs in
maintaining updated community health data
5. I am satisfied with the services of BHERTs in ensuring
regular communication with our constituents on health
issues and awareness