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The primary job of the Support Coordinator is developing an annual support plan for each client and assist in accessing services needed.  Support Coordinator then monitor those services to ensure they are being provided as authorized.

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* 1. Name of Individual served:

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* 2. Respondents Name:

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* 3. Relationship to Individual served:

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* 4. My current Support Coordinator is

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* 5. At your most recent plan meeting do you feel that your Support Coordinator listened and understood your needs and wants?    

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* 6. About how often do you see your Support Coordinator?

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* 7. Would you like to see her more often?  

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* 8. Was the planning meeting held at a convenient location and time?

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* 9. Are/were you treated with courtesy and respect by your Support Coordinator? 

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* 10. How would you rate your Support Coordinator overall?

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* 11. Do you receive services from any of these providers? (check all that apply)

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* 12. How satisfied with the quality of services and programs offered to your family by these
providers? 

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* 13. Are there any issues we can help you resolve with these providers?

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* 14. Are there any services your family currently needs that are not available in Dent County?

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