Overall Satisfaction

erall Satisfaction
n all the considerations, how satisfied are you with your
umer directed support program?
likely would you be to recommend a consumer directed
ort program in your county to a friend in a similar situation?
Very
satisfied
the consumer directed support program met the expectations Exceeded
Neither satisfied
nor dissatisfied
Very
dissatisfied
H'Q • • • • •
Very Neither likely
Very
likely
Sfa
nor
•
unlikely
• •
unlikely
• •
T
Met
Expectations
1
Failed
Expectations
, . . Expectations
were set for you by your case manager and county social ~n
ces department? • QTQ • • • •
is the one thing that would have the greatest impact on your satisfaction with consumer directed
;ing beyond consumer directed supports to your overall quality of life, on the following pages
e indicate how much you agree or disagree with each statement. Please complete these sections
the perspective of the person with a developmental disability. The person who has the
lopmental disability should be directly involved in completing this survey as much as possible.
idependenCe I Mobility
can (even if someone helps me because of my disability) get
/Control /Privacy Agre
Disagre
• • • •
Strongly Somewhat Neither Somewhat Strongly
have control over my daily schedule • • •
have privacy to be alone or with people 1 choose • • JSC • •
Dnly people who are supposed to know my personal
nformation have access to it • tar • • •
can set desired outcomes (goals) for myself • • • a-•
can decide about how 1 spend my money • • • • Or
can make decisions that will affect my future • • • •
am satisfied with my current level of independence • • • fir •