Overall Satisfaction

Overall Satisfaction
1. Given all the considerations, how satisfied are you with your
consumer directed support program?
2. How likely would you be to recommend a consumer directed
support program in your county to a friend in a similar situation?
7*7 J
satisfied
Neither satisfied
nor dissatisfied
V e r
y
dissatisfied
• A • • • • •
Very
likely
—I
E x c e
3. Has the consumer directed support program met the expectations r,
that were set for you by your case manager and county social
Neither likely
nor unlikely
1
Very
unlikely
T
• Q • • • • •
e d
^
Met Failed
Expectations Expectations Expectations
services department? • A • • • • •
4. What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports? /t/M.Mp0A/JWlL; JAM ad/iMU/ifAjrfhierftoe
Thinking beyond consumer directed supports to your overall quality of life, on the following pages^.
please indicate how much you agreeor disagree with each statement. Please complete th^sesections
from the perspective of the person with a developmental disability. The person who has the
developmental disability should be directly involved in completing this survey as much as~pbssible.
Independence I Mobility/Control/Privacy AGRE DISAGRE
g g ^ g ^ n a n J Strongly Somewhat Neither Somewhat Strongly
1. I can (even if someone helps me because of my disability) get
to where I want to go • J • • •
2. I have control over my daily schedule • _ • • •
I have privacy to be alone or with people I choose • _ • • •
CO
4. Only people who are supposed to know my personal
information have access to it • _ • • •
5. I can set desired outcomes (goals) for myself • • • •
6. I can decide about how I spend my money • • • _ •
7. I can make decisions that will affect my future • • • _ •
8. I am satisfied with my current level of independence • _ • • •