This document is a questionnaire about a PMC program that provides family planning and health services. It asks respondents for their name, how they learned about the program, what documents they needed to participate, which topics were discussed in seminars like marriage and STIs, if they found the services helpful, and how they would rate aspects of the program like the venue, teaching materials, and the counselor who conducted their session.

1. QUESTIONNAIRE
Name (optional) ________________________
QUESTIONS ANSWERS
1. How were you informed about the program?
_____ Barangay hall bulletin board
_____ Barangay Health Center
_____ Health worker
_____ Neighbor
_____ Others
2. What were the documents required for you to
avail the PMC program services?
3. Check the following topics that were
discussed during the seminar
_____ Marriage and Relationships
_____ Human Sexuality
_____ Maternal, Child and Neonatal Health
_____ Family Planning
_____ STIs including HIV/AIDS
_____ Responsible Parenthood and Home Management
_____ Others
4. In your honest opinion, do you think the PMC
program services were helpful?
5. Please rate the following:
Venue
Time constraint
Teaching material
Very Satisfactory Satisfactory Needs Improvement
6. Please rate the PMC Counselor who
conducted yoursession:
Grooming
Able to describe the purpose or desired
outcome
Ensure the task is clear and acceptable
Provide information
Clarify individual contribution
Summarize the discussion
Manage the interaction
Very Satisfactory Satisfactory Needs Improvement