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?
Very
satisfied
3. Has the consumer directed support program met the expectations Exceeded
that were set for you by your case manager and county social
services
Neither satisfied
nor dissatisfied
Very
dissatisfied
)&•••• • •
Very Neither likely Very
likely
n o r
unlikely unlikel
E x p c c V > t i o n s
e set ror you by your case manager and county social TjKf w r
Met
Expectations
T 'i
Failed
Expectations
department? I M • pj Q Q • •
4. What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports?
Thinking beyond consumer directed supports to your overal quality of life, on the folowing
please indicate how much you agree or disagre with each statement. Please complete thes
from the perspective of the person with a developmental disability. The person who ha
developmental disability~should be directly involved in completirig this survey as much as"possib
jn^eP^ndenC^ Mobility /Control /Privacy
1. I can (even if someone helps me because of my disability) get
Agree
Disagre
Strongly Somewhat Neither Somewhat Strongly
to where I want to go • • • •
2. I have control over my daily schedule • • • •
I have privacy to be alone or with people I choose • • • • •
CO
4.
5.
Only people who are supposed to know my personal
information have access to it
I can set desired outcomes (goals) for myself
•
•
to •
•
• •
6.
7.
I can decide about how I spend my money
I can make decisions that will affect my future... .
• •
a •
•
•
•
a
CO
I am satisfied with my current level of independence • a • •
r