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?
Very
satisfied
T
5Pu
Very
likely
Neither satisfied
nor dissatisfied
Very
dissatisfied
• • • • •
Neither likely Very
' nor unlikely unlike!;
1
iyh • • • • •
3. Has the consumer directed support program met the expectations Exceeded s Met
that were set for you by your case manager and county social
E x p
f^?
Expectations
— = ^ - 1 = - ^ F
services department? Ql Q Q • Q Q Q
4. What is the one thing that would have the g
supports? -^Tb L^jt inne. i
ami,
( Y L a U R N ^ry^^r^^a
Faded
Expectations
factiojj with consumer directed
5
Thinking beyond consumer directed supports to youroverall quality of life, on the following pages\
please indicate how much you agreeor disagree "with each'steterrient. Please compiefethesesertions
from the perspective of the person with a developmental disability. The person wholhas;the:^:DB?
developmental disability should be directly involved in completing this survey as much as possible. ; :
jnd^pendenCi^ Mobility/Control/Privacy
1. I can (even if someone helps me because of my disability) get
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
5.
6.
7.
8.
can set desired outcomes (goals) for myself,
can decide about how I spend my money ..
am satisfied with my current level of independence
Agree
Strongly Somewhat
• • •
• • •
• • •
• • •
• • •
• • •
• • •
• • •
Disagree\ y
Neither Somewhat Sgoogly
m •
p •
or •
•