Overall Satisfaction

Overall Satisfaction"! Neither satisfied
s, now sausnea are you
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wun your r—» i—i
r
consumer directed support
Very Neither likely Very
er
y nor dissatisfied .. e
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satisfied dissatisfied
program? U U Qi U U U
1. Given all the considerations, how satisfied are you with your
.... .. , j- * j likely nor unlikely unlikely
2. How likely would you be to recommend a consumer directed — —-—i 1—
q Has the consumer directed support program met the expectations Exceeded Met Failed
J
- 1 1
, , r-r r a r- Expectations Expectations Expectations
that were set for you by your case manager and county social ~n ~ _ r T J ~
support services program department? in your county to a friend in a similar situation? . . [_j • Qj • £y • 1J1 Q Q| • Q • Q •
4. What is the one thing that would have the.greatest impact on your satisfaction with consumer directed
supports? ^ i>
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Thinking beyond consumer directed supports to your overall quality of life, on the f_lowing_pag§§g|9i
please indicate how much you agree or disagree with each statement. Please complete these sections
from the perspective of the person with a developmental disability. The person who has the
developmental disabihty should be directly involved in joompjeting this survey as much as possible. _.jr,r
Neither Disagre
1 can (even if someone helps me because of my disability) get Strongly Somewhat
to where 1 want to go •
Somewhat Strongly
• • •
Independence | Mobility / Control / Privacy Agre
2. 1 have control over my daily schedule • • • •
3. 1 have privacy to be alone or with people 1 choose.......... • w • • •
4. Only people who are supposed to know my personal
• • • a
5. 1 can set desired outcomes (goals) for myself • • a
1 can decide about how 1 spend my money • • • •
CD
7. 1 can make decisions that will affect my future • • • •
• •
?8- 1 am satisfied with my current level of independence ....... a'
•