Overall Satisfaction

Overall Satisfaction Neither satisfied
V e r
*
satisfied
nor dissatisfied
W e r
* J
dissatisfied
1. Given all the considerations, how satisfied are you with your ' ' '
consumer directed support program? —I —I U LI LI LI
2. How likely would you be to recommend a consumer directed
Very Neither likely Very
noru kely unli
f' | kely
support program in your county to a friend in a similar situation? . . ^ _) Q Q __ __ Q
3. Has the consumer directed support program met the expectations Met Failed
, . , , r CJ r Expectations Expectations Expectations
that were set for you by your case manager and county social « ^ •
services department? • _ • • • • Q
4. What is the one thing that wouJd have the greatest impact on your satisfaction with consumer directed
supports? fl^vx .( i,n d#'cr»(tf A^tf , i WQ 1
^ ^Jfl^tiK
Thinking beyond consumer directed supports to your overall quality of life, on the foltow|ngj^ges^_ye
please indicate how much you agree or disagree with each statement. Please complete thes£S^)t|orjs
from the perspective of the person with a developmental disability. The person who h^the^; z=-£r
developmental disability should be directly involved in completing this survey as much as possible. _=
INDEPENDENCE \ Mobility /Control /Privacy
to where I want to go.
2. I have control over rm,
3. I have privacy to be a
4. Only people who are supposed to know my personal
information have access to it
5. I can set desired outcomes (goals) for myself Jmv^y. Pw*<
6. I can decide about how I spend my money.
7. I can make decisions that will affect my future. .(.^$U^).
8.
Agre
Strongly Somewhat
Neither Disagre
• • • •
Somewhat Strongly
• • • • a
• • • •
• J • • • •
• • •
• • • a
• • • •
. • m • • •