Overall Satisfaction

——••—-I /
Overall Satisfaction I Neither satisfied
;^_7 . nor dissatisfied
satisfied dissatisfied
1. Given all the considerations, how satisfied are you with your _ __ ' *
consumer directed support program? y-* LJ LJ LJ U LJ LJ
V e r
y
Very Neither likely Very
. How likely would you be to recommend a consumer directed
nor lkely
"f
u l U i k e l y
support program in your county to a friend in a similar situation? .. ^ [] Q Q [] Q []
. 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 "^i i—
services department? r^j Q Q Q • Q Q
What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports? lAtL /Z3f)j?sJ g m jlJA&YZ^H- /thaji/jl. rf\JL^
bfateaf/&ASAJ>/)U^ sstt^J^y-rtjOML. &}-JUAJL £>t6A OUfYl ^ jp^fiLAsJclt/?^
Thinking BEYOND CONSUMER DIRECTED^SUPORTS TO YOUR overall QUALITY of life, ON THE FOLOWING
PLEASE INDICATE HOW MUCH YOU AGRE OR DISAGRE WITHEACFSTEITEMENT . Please COMPLETE THES
FROM ^PERSPECTIVE of the PERSON with a DEVELOPMENTAL DISABILITY. The PERSON WHO HASTFIE
DEVELOPMENTAL DISABILITY SHOULD be DIRECTLY INVOLVED IN'COMPFETIN G THIS SURVEY AS MUCH AS P
J nC
i e
P^ n
dence | Mobility /Control /Privacy Agree Disagree
Strongly Somewhat Neither Somewhat Strongly
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 Drivacv to be alone or with neni
Only people who are supposed to know my personal
information have access to it
5. I can set desired outcomes (goals) for myself
6. I can decide about how I spend my money . .7
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