Overall Satisfaction

Overall Satisfaction
Neither satisfied
.._7. nor dissatisfied
satisfied dissatisfied
Given all the considerations, how satisfied are you with your ~JT „ _ -
consumer directed support program? y\ LI LI LJ LJ LA LJ
V E L
7
Very Neither likely Very
How likely would you be to recommend a consumer directed " F Y \j— NORU
F KELY
£ L Y
" " T
support program in your county to a friend in a similar situation? .. [] ft 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 *&*m< Expectations ___tauons
services department? • Q Q Q Q Q
What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports?
rhinking beyond consumer directed supports to your overall quality of life, on the following pages" t
)lease indicate how much you agree^or disagree with eaxl^stetement. Please complete these sections *
rom the perspective of the person1 with a developmentardisability. The person who has T H E Z - ; V -
levelopmental disability should be directly involved INWRN^eting this survey at much" as ffsslble^?^:
^ep^denC^ Mobility/Control/Privacy
I can (even if someone helps me because of my disability) get /
to where I want to go |VJ
I have control over my daily schedule Qj|
I have privacy to be alone or with people I choose ...... |^
Only people who are supposed to know my personal
information have access to it..........
I can decide about how I spend my money
I can make decisions that will affect my future
I am satisfied with my current level of independence
Agree Disagree
Strongly Somewhat Neither Somewhat Strongly
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