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? ..
3. Has the consumer directed support program met the expectations
that were set for you by your case manager and county social
Very
satisfied
Neither satisfied
nor dissatisfied
Very
dissatisfied
n m • • • • •
Very
likely
Exceeded
Expectations
Neither likely
nor unlikely
Very
unlikely
• •••••
Met
Expectations
Failed
Expectations
services department? _ _ _ • • • • • •
4. .What is the one thing
supports?
Thinking beyond consumer directed supports to your overall quality of life, on the following pages s
please indicate how much you agree or disagree with each statement. Please complete these sections
from the perspective of the person with a developmental disability. The person who has the
developmental disability stioufd be" directly involved incompleting this survey as much as possible.
5.
6.
7.
8.
Independence | Mobility /Control /Privacy Agree Disagre
____________________________ Strongly Somewhat Neither Somewhat Strongly
1. I can (even if someone helps me because of my disability) get
to where I want to go
2. I have control over my daily schedule
3. I have privacy to be alone or with people I choose
4. Only people who are supposed to know my personal
• • • •
• • • •
• a • • •
• m • • •
• • • a
• • a •
• • • • •
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