Overall Satisfaction

Overall Satisfaction
7*7
satisfied
r
Neither satisfied
nor dissatisfied
V e ,
T
dissatisfied
Given all the considerations, how satisfied are you with your ' r-^n r~l n Fl ri
consumer directed support program? LJ LJ U LI LI LJ
Very Neither likely Very
How likely would you be to recommend a consumer directed noruniikely ^fflL.
support program in your county to a friend in a similar situation? .. Q jgf Q Q Q Q Q
Has the consumer directed support program met the expectations Met Failed
.. . j. i , r
. , Expectations Expectations Expectations
that were set for you by your case manager and county social -nr—— ^ —
services department? • JEf • • • • •
What is the one thing that would have th§ greatest impact on your satisfaction with consumer directed
Supports? /Vfcv U4y -fr> -CA//, £J 0v\ ^^VIW^L s*~p0*St~ IS+K&
hinking beyond consumer directed supports to your overall quality of life, on the following pages. J
lease indicate how much you agree or disagree with each statement Please complete these sections "
om the perspective of the person with a developmental disability. The person who has the_
evelopmental disability should bedirectly involved in completing this survey as muchas possible!^
Independence | Mobility/ Control/ Privacy Agree Disagree
•••^'••••••••••••••••B Strongly Somewhat Neither Somewhat Strongly
I can (even if someone helps me because of my disability) get
to where 1 want to go
1 have control over my daily schedule •
1 have privacy to be alone or with people 1 choose •
• • •
a •
a •
a
•
a
• a • a
Only people who are supposed to know my personal
information have access to it.....
1 can set desired outcomes (goals) for myself
a*
• • ar • a
1 can decide about how 1 spend my money
1 can make decisions that will affect my future
1 am satisfied with my current level of independence
• •
•
J2T •
•
• •
a •
•
a