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Independent Living Institute, LLC

Satisfaction Survey

To: Persons Served, Parents, and Guardians:

Instructions: Please rate the following questions by circling the appropriate letter:

Outstanding Very Satisfactory Satisfactory Not Satisfactory

1. Are you receiving the services included in your IPP?

Outstanding

Very Satisfactory

Satisfactory

Not Satisfactory

2. How would you rate your ILI services?

Outstanding

Very Satisfactory

Satisfactory

Not Satisfactory

3. How would you rate your ILI staff?

Outstanding

Very Satisfactory

Satisfactory

Not Satisfactory

4. Are you learning the skills and receiving the support needed to maintain an independent and productive life?

Outstanding

Very Satisfactory

Satisfactory

Not Satisfactory

5. Is your ILI staff responsive to your changing situation and your needs?

Outstanding

Very Satisfactory

Satisfactory

Not Satisfactory

6. Do you know your rights and responsibilities as a consumer of services?

Outstanding

Very Satisfactory

Satisfactory

Not Satisfactory

7. Are you treated with dignity and respect by ILI staff?

Outstanding

Very Satisfactory

Satisfactory

Not Satisfactory

8. Are you achieving your personal goals?

Outstanding

Very Satisfactory

Satisfactory

Not Satisfactory

What are three (3) areas the Independent Living Institute could improve?