Overall Satisfaction

Overall Satisfaction «
^ ^ ^ ^ ^ V Neither satisfied ^
satisfied rdiss tisfied dissatisfied
Given ail the considerations, how satisfied are you with your ' - ' '
consumer directed support program? £3 Qj M Ql QJ W UJ
Very Neither likely Very
How likely would you be to recommend a consumer directed "° r k e l y ulUi
"f' | ke
' y
support program in your county to a friend in a similar situation? .. 81 Q E) SI 13 3 Q
Has the consumer directed suppbrt program met the expectations Exceeded Met Failed
. . . . . . • Expectations Expectations Expectations
that were set for you by your case manager and county social ^ —
services department? .V; @| (v| (3 01 13 13 13
What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports? V Z A A I ^ ^ ^ ^ F ^ ^ X F V F R J
WIDE » JHIIRTTAJ 4 CFEJ&R VI*/JH *F
Thinking beyond consumer directed supports to your OVERALL QUALITY OF LIFE, on the fo lowing P ^ F
please indicate how much you agree or disagree with each statement. Please complete these sections
from the PERSPECTIVE OF THE PERSON WITH A DEVELOPMENTAL DISABILITY, The person who has the
developmental disability should be directly involved in completing this survey as much as possible.
1.
Independent MOBILITY/ CONTROL / PRIVACY ^ N E I T H E R J S T T - *
I can (even if someone helps me because of my disability) get
(3 •
2. m M 13
3. SI • M ul
4.
Only people who are supposed to know my personal
_I • SI
5. IS 13 13
6. IS M J
7. • 13 J 13
8. I am satisfied with my current level of independence 13 (3 13