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Overall Satisfaction

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<strong>Overall</strong> <strong>Satisfaction</strong><br />

1 Given all the considerations, how satisfied are you with your<br />

consumer directed support program?<br />

How likely would you be to recommend a consumer directed<br />

support program in your county to a friend in a similar situation? . .<br />

Has the consumer directed support program met the expectations<br />

that were set for you by your case manager and county social<br />

services department?<br />

Very<br />

satisfied<br />

Neither satisfied<br />

nor dissatisfied<br />

Very<br />

dissatisfied<br />

^ • • • • • •<br />

Very<br />

likely<br />

Neither likely<br />

nor unlikely<br />

Very<br />

unlikely<br />

l§a • • • • •<br />

Exceeded Met Failed<br />

Expectations Expectations Expectations<br />

Q • • • • •<br />

4. What is the one thing that would have the greatest impact on your satisfaction with consumer directed<br />

supports? CoyvfxKu^ a-_> i f- fS — cW.f ^ c W ujc-Le^^<br />

Thinking beyond consumer directed supports to your overall quality of life, on the followjng^ges ,<br />

please indicate how much you agreeor disagree with each statement. Please complete thesesections<br />

from the perspective of the person with a developmental disability. The person who.has^e..<br />

developmental disability should be directly involved in completing this survey as much asjjpssibte.. ;<br />

I Independence Mobility/Control/Privacy Agree Disagree<br />

7<br />

—— • Strongly Somewhat Neither Somewhat Strongly<br />

1. I can (even if someone helps me because of my disability) get<br />

to where I want to go ><br />

2. I have control over my daily schedule.<br />

3. I have privacy to be alone or with people I choose<br />

4. Only people who are supposed to-know my personal<br />

information have access to it.. ^ . •<br />

5. I can set desired outcomes (goals) for myself.<br />

6. I can decide about how I spend my money ...<br />

I can make decisions that will affect my future.<br />

8. I am satisfied with my<br />

• • a •<br />

• a a a<br />

• • a •<br />

• • • •<br />

• • • a<br />

• • • a<br />

a a a a<br />

a • 5 • a

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