Overall Satisfaction

Overall Satisfaction i
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?
Has the consumer directed support program met the expectations
that were set for you by your case manager and county social
services department?
Very
satisfied
Neither satisfied
nor dissatisfied
Very
dissatisfied
T
1
• • • • •
Very
likely
Neither likely
nor unlikely
Very
unlikely
T
1
• • • • • •
Exceeded
Met
Failed
Expectations
• • •
Expectati lectati^hs
jaa •
Expectations
•
What is the one thingjhat would have the greatest impact on your satisfaction with consumer directed
supports? y M i r Com^nn vLoJr>(x\ ryJ- p/iv^-Wl \^A>f (
T
n d
&Sfc!09 bey° consumer directed supports to your overall quality of life, on the following pages
P'ease indicate how much you agree or disagree wifreacFstetemerit.- Please completethese sectionf"
^i 1
? the perspective of the person with a developmental disability. The person who has the ?i
developmental disability should be directly involved incompleting this survey as much^pSssiblet" f^f
Independence | Mobility/Control/Privacy
to where I want to go
I have control over my daily schedule.
I have privacy to be alone or with people I choose Q
n ,
h. P y people who are supposed to know my personal
^information have access to it
I can set desired outcomes (goals) for myself.
I can decide about how I spend my money
; I am satisfied with my current level of independence
Agree
Strongly Somewhat Neither
t
Disagree
Somewhat Strongly
• • • •
• • a •
. • • • •
• • • • a
T a • a
• a K • •
• • a •
. • b • • a