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?
Neither satisfied
V e r y
.*? * nor dissatisfied
satisfied
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dissatisfied
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Very Neither likely Very
likely nor unlikely unlikely
3. Has the consumer directed support program met the expectations Exceeded Met Failed
... . , . i . • , Expectations Expectations Expectations
that were set for you by your case manager and county social ~n ^-i \^
services department? • Q • • • Q CJ
4. What mat is tne the one tning thing tnat that wouia would nave have the greatest impact onyour^atisfaction with consumer dsrecl directed
supRorts?
Thinking beyond consumer directed supports to your overall quality of life, on the following pages
please indicate how much you agree or disagree with each statement. Please complete thesesections
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.
^ndepende^C^ Mobility/Control/Privacy
1. I can (even if someone helps me because of my disability) get
to where I want to go
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
information have access to it
6.
7.
8.
Li
am satisfied with my current level of independence Q £^
Agree Disagree
Strongly Somewhat Neither Somewhat Strongly
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