Overall Satisfaction

Overall Satisfaction
Given all the considerations, how satisfied are you wrn your
consumer directed support program?
How likely would you be to recommend a consumer drected
support program in your county to a friend in a simila- situation?
Very
satisfied
Neither satisfied
nor dissatisfied
Very
dissatisfied
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Very
likely
T
Has the consumer directed support program met the s^ectations Exceeded
that were set for you by your case manager and court 1
/ social
services department?
Neither likely
nor unlikely
T
Very
unlikely
r
• )_!•••••
Met
Expectations Expectations
Failed
Expectations
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What is the one thing that would have the greatest irrcsct on your satisfaction with consumer directed
supports? , n , .
Thinking beyond consumer directed supports to youro*erall quality of life, on the following pages
please indicate how much you agree or disagree with SECT, 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 zmpieting this survey as much as possible
jndependenC^J Mobility/ Control /Privacy
I can (even if someone helps me because of my dKbility) get
to where I want to go Q*l
I have control over my daily schedule ~j
I have privacy to be alone or with people I choose. ^
Only people who are supposed to know my persora
information have access to it
I can set desired outcomes (goals) for myself.... Q
I can decide about how I spend my money [—j
I can make decisions that will affect my future... Q
I am satisfied with my current level of independent Q
Agree Disagree
Strongly Somewhat Neither Somewhat Strongly
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