Overall Satisfaction

Overall Satisfaction
Given all the considerations, how satisfied are you with your
J
Neither satisfied
6
"? , nor dissatisfied Very
satisfied dissatisfied
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consumer directed support program? LJLI LI LI LI LJ LI
Very Neither likely Very
noru
f kely
una
f* ly
How likely would you be to recommend a consumer directed
support program in your county to a friend in a similar situation? .. Q Q Q Q Q Q
Has the consumer directed support program met the expectations Exceeded Met Failed
that were set for you by your case manager and county social
E x p t e
f ^ Expectations
services department? O^Q • • • • •
^/Vhat is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports?
hinking beyond consumer directed supports to your overall quality of life, on the following pages
>lease indicate how much you agree or disagree with each statement. PleaseTcomplete these sections
ram the perspective of Jthe person with a developmental disability. The person who has the
leyelopmental disability should be directly involved in completing this survey as much as possible" '
J09!gpendence:| Mobility /Control /Privacy
I can (even if someone helps me because of my disability) get
to where I want to go
I have control over my daily schedule
£1 have privacy to be alone or with people I choose.......
•"• Only people who are supposed to know my personal
r
Agree
Strongly Somewhat Neither
Disagree
Somewhat Strongly
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