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* 1. Do you eat your meals and snacks when you want?

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* 2. Do you have the opportunity to eat your choice of food for meals and snacks?

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* 3. Do you go to bed when you want?

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* 4. Do you get out of bed when you want?

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* 5. Do you have the opportunity to be involved in activities of your choice?

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* 6. Do you have the opportunity to have visitors in your home when you want?

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* 7. If you share an apartment or a bedroom would you like a change?

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* 8. Are you able to access spending money when you want?

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* 9. If you would like a personal response to your comments, please leave your name and phone number below.

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