Overall Satisfaction

Overall Satisfaction Neither satisfied
V eT
y nor dissatisfied Very
satisfied dissatisfied
Given all the considerations, how satisfied are you with your ' FA_ ' „ _
consumer directed support program? 1—1 LJ LJ LJ LJ LJ
How likely would you be to recommend a consumer directed
support program in your county to a friend in a similar situation?
r
Very Neither likely Very
likely nor unlikely unlikely
• • • • • •
Has the consumer directed support program met the expectations Exceeded Met Failed
. . . , x , , i . I
that were set for you by your case manager and county social
Expectations
~n
Expectations
~r—
Expectations
E
-i
services department? ., Q CJ Q J3 Q Q Q
What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports? y-o / W / ? -^S£*&/ISK DRTD -PBN CJ- UI )^PH Q-Hw KIDS &N ^ S)P /y? O AJU^ 4-N>
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Thinking beyond consumer directed supports to your overall quality of life, on the followjng pjges.£ \
please indicate how much you agree or disagree" with each statement. Please complete thesejsections j^J^g^:^
from the perspective of the person with a developmental disability. The person who
developmental disability should be Erectly Involved in completing this survey as much as possible:;^
Independence I Mobility
1. I can (even if someone helps me because of my disability) get
/Control /Privacy Agree Disagre
Strongly Somewhat Neither Somewhat Strongly
to where I want to go LJ PTJF
2. I have control over my daily schedule LJ •
3. I have privacy to be alone or with people I choose LJ
4. Only people who are supposed to know my personal
information have access to it Q Q|
5. I can set desired outcomes (goals) for myself.... • jar
6. I can decide about how I spend my money Qj
7. I can make decisions that will affect my future Q| LJ
8. I am satisfied with my current level of independence LJ 12
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