Overall Satisfaction

Overall Satisfaction Neither satisfied
^ er
y
satisfied
nor dissatisfied ,. ,. V- .
dissatisfied
Given all the considerations, how satisfied are you with your VY 7
• • • • • •
consumer directed support program? ^
Very Neither likely Very
likely
n o r
unlikely unlikely
How likely would you be to recommend a consumer directed ' y X ^- •
support program in your county to a friend in a similar situation? . . Q
Has the consumer directed support program met the expectations V%£%L
Q
E x
Q
e
a t i n n s
• Q L|
ExPectations
that were set for you by your case manager and county social O/ r-» r-* n r~i ri
services department? ^ • • LI LI U LI
.— : : ^TU'RIITYTI:^ •
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 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
1
- - - 1 Strongly Somt
1. I can (even if someone helps me because /of my disability)
JIJJS IIIB UCUOUac Ul Illy uuaumiji; a^'v _ _ ^ »
2. I have control over my daily sche^te^^ • • Q LJ
to where I want to go. frfcd&lpfafiOff '^p^f^
mory\
3. 4. I Only have people privacy who to be are alone supposed or with to people know my I choose personal