Overall Satisfaction

OVERALL SATISFACTION
Given all the considerations, how satisfied are you with your
consumer directed support program?
How likely would you be to recommend a consumer directed
support program in your county to a friend in a similar situation?
Very
satisfied
Very
likely
3. Has the consumer directed support program met the expectations Exceeded
, . , . , . . . Expectations
Neither satisfied
nor dissatisfied
Neither likely
nor unlikely
1
Very
dissatisfied
Very
unlikely
1
• • • • • • •
Met Failed
Expectations Expectations
that were set for you by your case manager and county social
services department? Q • • • • • •
What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports?
t
I
A ' K _ _ ft ill) ....... il A / -
1 o
Thinking beyond consumer directed supports to your overall quality of life, on the foHowing^ges^, r,
please indicate how much you agree or disagree'with each statement. Please complete the^s^Jtiohs
from the perspective of the person with a developmental disability. The person who hj||the^~ ^
developmental disability should be"directly involved in completing this survey as"much as possible!""
2.
3.
4.
5.
6.
7.
8.
INDEPENDENCE | Mobility / Control / Privacy Agree Disagree
Strongly Somewhat Neither Somewhat Strongly
1. I can (even if someone helps me because of my disability) get
Only people who are supposed to know my personal
I can decide about how I spend my money
I am satisfied with my i
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• • a a
a m • • •
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a a a • •
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a • •
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