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QUESTIONNAIRE

SURVEY TO SUPPORT THE STUDY OF

Implementation of Republic Act 9994 otherwise known as The Expanded Senior

Citizens Act

Providing survey in this study is voluntary. There is no penalty if you choose not

to respond. However, maximum participation is encouraged so that the data will be

complete and representative. Your survey instrument will be treated as confidential.

Identifying information will be used only by persons engaged in, and for the purposes of

the survey.

1. Profile of the respondents

Age: 60-65 (__)

66-70 (__)

71-75 (__)

76-80 (__)

81 and above (__)

Sex: Male: (__) Female: (__)

Source of income:

Employment: ___________________ Others:__________________

Pension received: ________________

Barangay:_____________________________

Direction: Please put a check mark in the items below. Use the scale given in choosing

your answer. Please feel free to answer questions in your most truthful opinion.
5- point Likert Scale on Extent of Implementation

1- Not implemented at all


2- Low level of implementation
3- Medium level of implementation
4- High level of implementation
5- Advanced level of implementation

Level of Implementation of Republic Act 9994 otherwise known


as the expanded Senior Citizens act
A. Rate the level of implementation of the following 5 4 3 2 1
benefits as to health services as mandated by the
expanded Senior Citizens Act.
1. 20% discount and exemption from the value-added tax on
the purchase of medicines.
2. 20% discount and exemption from the value-added tax on
the professional fees of attending physician/s in all private
hospitals, medical facilities, outpatient clinics and home
health care services.
3. Free medical and dental services in government facilities.
4. The DOH, in coordination with local government units
institutes a national health program, trains community-
based health workers among senior citizens and health
personnel to specialize in the geriatric care and health
problems of senior citizens
5. All indigent senior citizens shall be covered by the
national health insurance program of PhilHealth.
6. Establishment of “senior citizens ward” in every
government hospital.
7. Free vaccination against the influenza virus and
pneumococcal disease for indigent senior citizen patients
B. Rate the level of implementation of the following 5 4 3 2 1
social benefits as mandated by the expanded Senior
Citizens Act.
1. 20% discount and exemption from the value-added tax on
the utilization of services in hotels and lodging
establishments, restaurants and recreation centers.
2. 20% discount and exemption from the value-added tax on
admission fees charged by theaters, cinema houses and
concert halls circuses, leisure and amusement.
C. Rate the level of implementation of the following 5 4 3 2 1
benefits as to public utility services as mandated by the
expanded Senior Citizens Act.
1. The grant of a minimum of five percent discount relative
to the monthly utilization of water not exceeding 30 m3.
2. 20% discount on the actual fare for land transportation
travel in public utility buses and jeepneys.
3. The grant of a minimum of five percent discount relative
to the monthly utilization of electricity supplied by the
public utilities not to exceed 100kWh.
4. 20% discount on the actual fare fordomestic air transport
services and sea shipping vessel based on the actual and
advanced booking.
D. Rate the level of implementation of the following 5 4 3 2 1
benefit as to education as mandated by the expanded
Senior Citizens Act.
1. The DepEd, TESDA and the CHED in consultation with
nongovermental organizations (NGOs) and Pos for
Senior Citizen institutes programs that ensures access to
formal and nonformal education.
E. Rate the level of implementation of the following 5 4 3 2 1
benefit as to employment as mandated by the
expanded Senior Citizens Act.
1. 15% Additional deduction from gross income of the total
amount paid as salaries and wages provided that the
annual income does not exceed the latest poverty
threshold
F. Rate the level of implementation of the following 5 4 3 2 1
benefits as to additional government assistance as
mandated by the expanded Senior Citizens Act.
1. Indigent senior citizens shall be entitled to a monthly
stipend amounting to Five hundred pesos (Php500.00).
2. Social safety assistance intended to cushion the effects of
economics shocks, disasters and calamities shall be
available for senior citizens which includes food,
medicines, and financial assistance for domicile repair.
3. Government grants special discounts in special programs
for senior citizens on purchase of basic commodities.
4. Provision of express lanes for senior citizens in all
commercial and government establishments; in the
absence thereof, priority shall be given to them
5. There shall be established Office for Senior Citizens
Affairs to be headed by a senior citizen who shall be
appointed by the mayor for a term of three (3) years
without reappointment.
Semi- stractured Interview Guide Questionnaires

1. Do you always use your discount priveleges?

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

2. What are the problems you encountered in the implementation of RA 9994?

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
QUESTIONNAIRE

SURVEY TO SUPPORT THE STUDY OF

Implementation of Republic Act 9994 otherwise known as The Expanded Senior

Citizens Act

Providing survey in this study is voluntary. There is no penalty if you choose not

to respond. However, maximum participation is encouraged so that the data will be

complete and representative. Your survey instrument will be treated as confidential.

Identifying information will be used only by persons engaged in, and for the purposes of

the survey.

2. Profile of the respondents

Age: 60-65 (__)

66-70 (__)

71-75 (__)

76-80 (__)

81 and above (__)

Sex: Male: (__) Female: (__)

Source of income:

Employment: ___________________

Pension received: ________________

Barangay:_____________________________