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
V c r
y
satisfied
Neither satisfied
nor dissatisfied
V e r
?
dissatisfied
• • • • • J^F •
Very Neither likely Very
likely nor unlikely unlikely
support program in your county to a friend in a similar situation? .. Q Q Q Q D Q
3. Has the consumer directed support program met the expectations Exceeded Met Failed
. . . , , . . . . Expectations Expectations Expectations
that were set for you by your case manager and county social ~n ^ — 7 — — ^ —
services department? • • • • • Q
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 your^yerall quality of life, on the following pages
please indicate how much you agree or disagree with eaclvstatement. 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 incompleting this survey as much as possible.
Independence J Mobility/Control/Privacy Agree Disagree
Strongly Somewhat Neither Somewhat Strongly
I can (even if someone helps me because of my disability) get
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
5. I can set desired outcomes (goals) for myself
6. I can decide about how I spend my money
7. I can make decisions that will affect my future
8.
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