Individual Program Plan (IPP) Feedback Form Survey

1.Please select your regional center:

2.Did your service coordinator listen to what is important to you/your family and use that information to help create a plan to meet your goals?

My Service Coordinator did not listen to what’s important to me at all.

My Service Coordinator listened to what’s important to me a little bit.

My Service Coordinator listened to what’s important to me.

My Service Coordinator listened a lot to what’s important to me.

I do not know how to answer this question.

I don’t want to answer this question.

3.Were you satisfied with the service providers the Regional Center had available for you to choose between?

Yes, we were satisfied with the service providers we could choose between

No, we were not satisfied with the service providers we could choose between

We were satisfied with some of the service providers we could choose between for our services, but not ALL the service providers.

I do not know how to answer this question.

I don’t want to answer this question.

4.Did your Regional Center provide you/your family with information about Self-Direction (Self-Determination Program, Participant-Directed Services) and using traditional provider services?

My regional center did not provide me with any information on Self-Direction.

My regional center did not provide me with enough information to make a choice between Self-Direction and traditional services.

My regional center provided me with some information about Self-Direction, but I would like more information.

My regional center did provide me with enough information to choose between Self-Direction and traditional services.

My regional center provided me with a lot of information so that I felt comfortable choosing between Self-Direction and traditional services.

I do not know how to answer this question.

I don’t want to answer this question.

5.Please select the best option that describes the information your regional center provided to you:

The information provided was very difficult to understand.

The information provided was somewhat difficult to understand.

The information provided was not difficult to understand.

The information provided was easy to understand.

The information provided was very easy to understand.

I do not know how to answer this question.

I don’t want to answer this question.

6.Did your service coordinator treat you with respect during your IPP meeting?