Overall Satisfaction

Overall Satisfaction Very
satisfied
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?
Has the consumer directed support program met the expectations Exceeded
• a
Neither satisfied
• • •
nor dissatisfied *^ j
dissatisfied
• ja
Very
Neither likely
• • •
Very
likely
nor unlikely unlikely
T
R
Met FaUed
Expectations Expectations
. • • • • EXPECTATIONS
that were set for you by your case manager and county social ~ n •
services department? J% • • • • • •
What is the one thing that would have the greatest impact on your satisfaction with consumer directed
supports?^ _ ___ .o, 3 ,— = — - ; ^ ^ ^
Thinking beyond consumer directed supports to your
P|^5^
OVERAH ^^5AW^^^SSS^^S^»^i
SB. fndicke how much you ag^rWsigre^'each statement. Please COMPTETEJ^.^chops.,
frbm the PERSPECTIVE of THE P E R ^ V ^ E ^ ^ N T E L DISABUITY^The
developmental disability should be directly involved in completing this survey as much AS possroie.
1.
Indepertd^nc^j / CONTROL / PRIVACY Agree
MOBILITY
Strongly Somewhat
I can (even if someone helps me because of my disability) get
to where I want to go ^ •
2. I have control over my daily s
3. I have privacy to be alone or
5.
6.
7.
'tit?'-- 5
* -'
Only people who are supposed to know my personal
information have access to it.. .;
I can set desired outcomes (goals) for myself.
I can decide about how I spend my money ...
I can make decisions that will affect my future.
8. I am satisfied with my current level of independence
Disagree
Neither Somewhat Strongly
• • • •
• ja • • •
• El • a •
• a • • •
a _ • • •
• • a •
• • o • •
• • • •