Overall Satisfaction

^Over-all 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?
3 Has the consumer directed support program met the expectations
that were set for you by your case manager and county social
services department?
E
Very
satisfied
Neither satisfied
nor dissatisfied
Very
dissatisfied
1
• • ^ • • • •
Very
likely
Neither likely
nor unlikely
E
Met
*^£
Expectations Expectations
Very
unlikely
r
Failed
Expectations
• • • • • • •
4. What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports? TJNDIHJ FC-A SCRINCEJSR
Thinking beyond consumer directed[supports to your overall quality of life, on the tofe^jn^^Eli^ 3
-^
please indicate how much you agree or "disagree with each statement. Please'complete theseisections
from the perspective of the person witha developmental disability. The person WHOTE^^'F:developmental
disability should be" directly involved in completing this survey as much as possjbte^ -_-
I Independence Mobility / Control / Privacy Agree Disagree
I Qtrnnoiv Snmpwhat Neither Somewhat Stron
1. I can (even if someone helps me because of my disability) get
• _ • • •
a 2. • • •
CO
I have privacy to be alone or with people I choose • • • •
4. Only people who are supposed to know my personal
• _ • • a
5. • • • •
6. • • • • •
7. I can make decisions that will affect my future • a • •
CO
f WJf-.ki-. - ...
I am satisfied with my current level of independence . • • • •