Survey Layananan

Form Survey

1. Responden Info

Nama Responden

Looks good!

Please enter your name.

Usia *

Looks good!

Please enter your Age

Gender *

Male

Female

2. Questionnaire

1 . Bagaimana Tingkat Kemudahan anda mendapatkan informasi terkait Pelayanan di PPKGBK?

Looks good!

Please enter your name.

Sangat Puas

Puas

Kurang Puas

Kecewa *

Saran/Masukan/Komentar

2 . Persyaratan Pelayanan

Looks good!

Please enter your name.

Sangat Puas

Puas

Kurang Puas

Kecewa *

Saran/Masukan/Komentar

3 . Prosedur/Alur Pelayanan

Looks good!

Please enter your name.

Sangat Puas

Puas

Kurang Puas

Kecewa *

Saran/Masukan/Komentar

4 . Waktu Penyelesaian

Looks good!

Please enter your name.

Sangat Puas

Puas

Kurang Puas

Kecewa *

Saran/Masukan/Komentar

5 . Biaya Pelayanan

Looks good!

Please enter your name.

Sangat Puas

Puas

Kurang Puas

Kecewa *

Saran/Masukan/Komentar

6 . Bagaimana kondisi Sarana Prasarana di GBK?

Looks good!

Please enter your name.

Sangat Puas

Puas

Kurang Puas

Kecewa *

Saran/Masukan/Komentar

7 . Respons Petugas Pelayanan

Looks good!

Please enter your name.

Sangat Puas

Puas

Kurang Puas

Kecewa *

Saran/Masukan/Komentar

8 . Layanan Konsultasi

Looks good!

Please enter your name.

Sangat Puas

Puas

Kurang Puas

Kecewa *

Saran/Masukan/Komentar