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
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satisfied
Neither satisfied
nor dissatisfied
V e r y
dissatisfied
Very Neither likely Very
likely nor unlikely unlikely
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support program in your county to a friend in a similar situation? .. |^ Q Q Q Q Q Q
3. Has the consumer directed support program met the expectations EXCEEDED MET FAILED
.. , , , . . . . Expectations Expectations Expectations
that were set for you by your case manager and county social ~n——— "-i
services department? • JSJ • • • • •
4. What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports? \OV\o^ niir rr^r.ci R P N G J L O S W-s A L I A A . H > R SlLT S C O
suports Thinking beyond consumer directed to your overall quality of life, on the following pages"
please indicate how much you agree or disagree with eacTiitetement Please complete these^sections
from the perspective of the person with a developmental disability. The person who has the, |Lv
developmental disability should be'directly involved in completingIhls survey as much aspossible. c
* ^
Independence | Mobility /Control /Privacy A G R E E DISAGREE
1. I can (even if someone helps me because of my disability) get
to where I want to go a
Strongly Somewhat Neither Somewhat Strongly
a a •
2. I have control over my daily schedule.... • • • •
a a I have privacy to be alone or with people I choose • •
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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 • • a •
8. I am satisfied with my current level of independence • • • •