Overall Satisfaction

Overall Satisfaction |
Given all the considerations, how satisfied are you with your
consumer directed support program?
How likely would you be to recommend a consumer directed
support program in your county to a friend in a similar situation?
Very
satisfied
Very
likely
Has the consumer directed support program met the expectations Exceeded
that were set for you by your case manager and county social Expectations
Neither satisfied
nor dissatisfied
Neither likely
nor unlikely
Very
dissatisfied
Very
unlikely
of • • • • • •
Met
Expectations
Failed
Expectations
services department? _ _ ( • • • • • •
/Vhat is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports?
Pfl US TP
our
"hinking
ilease indicate
beyond
how
consumer
much
directed
you agree
supports
or disagre
to your
with
overal
each
quality
statement.
of life, on the fol
Please
rom the perspective of the person with a developmental disability. The person
compl
levelopmenta l disability should be directly involved in completing this survey as much
w
JH^PQHdenCe I Mobility / Control / Privacy Agree Disagree
Strongly Somewhat Neither Somewhat Strongly
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 Nfe. (^PVP...
I have privacy to be alone or with people I choose
Only people who are supposed to know my personal
I can make decisions that will affect my future
I am satisfied with my current level of independence
• or • a a
• • ef • •
• a a •
J • a • a
• • • • a
• • • a
• • a a
• a • •