Overall Satisfaction

Overall Satisfaction I
-_«___•—«—«___«_________________
V e r
y nor dissatisfied _
—
~ ~ —
• satisfied dissatisfied
Given all the considerations, how satisfied are you with your • Q l_f Q Q Q Q
consumer directed support program? ^ J
^ ^
Very Neither likely Very
likely
n o r
unlikely unlikely
How likely would you be to recommend a consumer directed —i——7 1 r
support program in your county to a friend in a similar situation? .. Q M Q Q Q Q Q
Has the consumer directed support program met the expectations £Z£L EX^ ANS Ex^lons
that were set for you by your case manager and county social "L. r~i Fl fcrf r~l HI
services Apartment? LI LI LJ LI ]4' LI LJ
What is the one thing that would have, the greatest impact on your satisfaction with consumer directed
supports? ^ Mmju tftWrJjubf L)/ ^uUiihA^ OK,
Thinking fcgyond consumer djrected supports to your overall quality of life, on the following pages
please indicate how much you agree or disagree with each stefiientj Please'completethesej|^ipns
from the perspective of the person with a developmental disability. The person who has the_
developmental disability should be directly involved in completing trite survey a¥much as pdssfojeV^
Independence I Mobility/Control/Privacy
1. I can feven if someon
to wr% e | w a n t to go.
2. I hav$ control over my daily schedule
3. I hav§ privacy to be alone or with people I choose...
4. Only people who are supposed to know my personal
inforo&ti on have access to it
5. I can 3^ desired outcomes (goals) for myself.
6. I can rSecide about how I spend my money ...
I can^ke decisions that will affect my future.
Agree
Strongly Somewhat Neither
Disagree
Somewhat Strongly
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