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* 1. Do you feel your loved one's needs are being met by the USS Direct Support Professional (DSP)?

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* 2. The DSP is knowledgeable on how to support my loved one.

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* 3. Is the relationship between the USS DSP and your loved one positive?

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* 4. Does the DSP assist your loved one with achieving his or her goals?

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* 5. How long has the current DSP worked with your loved one?

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* 6. If your loved one has needed help finding their voice (Advocacy), has USS been a helpful resource and advocate?

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* 7. Please rate the following pertaining to your Qualified Professional (QP).

  Extremely Satisfied Satisfied Neutral Dissatisfied Extremely Dissatisfied
The amount of communication / contact with the USS QP.
The knowledge my QP has of the waiver and services.
The knowledge my QP has of my loved one's needs and goals.
My QP is meeting my expectations.

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* 8. Rate your experience with the annual ISP (plan) process.

  Strongly Agree Agree Neutral Disagree Strongly Disagree
My USS QP advocated for the services and hours that I wanted.
My USS QP informed me of my options for services.
I felt included in the annual plan year process.
I participated in the writing of the goals.
My QP took time and prepared me BEFORE the actual ISP (plan) meeting.

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* 9. Do you feel your loved one is exercising his or her rights.

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* 10. If this is your FIRST year with USS, please rate the following based on your new beginnings with USS.

  Extremely Satisfied Satisfied Neutral Dissatisfied Extremely Dissatisfied Not applicable (N/A)
How satisfied were you with the information you received about USS?
How satisfied were you with the communication you received through the process?
How satisfied were you with the response time from the in-take department?

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* 11.

How would you rate your overall experiences with United Support Services (USS)?

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* 12.

Do you have any other questions or comments to help USS maintain it's quality support services?

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THANK YOU for taking the time to complete our survey!

Your feedback is very important to USS!

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