Overall Satisfaction

Overall Satisfaction Neither satisfied
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y nor dissatisfied ,. f\. .
satisfied
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dissatisfied
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1. Given all the considerations, how satisfied are you with your
consumer directed support program?
Very Neither likely Very
2. How likely would you be to recommend a consumer directed noruniikeiv
support program in your county to a friend in a similar situation? . . (~J fj^ • Q L_ Gl L_
3. Has the consumer directed support program met the expectations Exceeded Met Faued
• • • 0 • • •
, . , Expectations Expectations Expectations
that were set for you by your case manager and county social ^ ^
services department?
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 you? overall quality of life, on the following pages ^
please indicate how much you agree or disagree witfTeach statement. Please complete these sections
from the perspective of the person with a developmental disability. The person who has the
developmental disability should be directly involved in completing this survey as much as possible.
Independence I Mobility/Control/Privacy Agree Disagree
• : I Strnnplv Somewhat Neither Somewhat Stron
1. I can (even if someone helps me because of my disability) get
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2. • • • •
I have privacy to be alone or with people I choose • • • •
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5.
Only people who are supposed to know my personal
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6.
7.
I can decide about how I spend my money
I can make decisions that will affect my future
I am satisfied with my current level of independence
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