This survey has been generated by Quality Trust for Individuals. If you have any questions, please contact us at 202-448-1457.


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* 1. What is going well for you?

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* 2. What things are not good in your life?

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* 3. What area of your life do you want things to stay the same?

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* 4. What area of your life do you want things to change?

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* 5. Quality Trust will do new monitoring in the Fall. What do you think is the most important thing we should look at?

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* 6. If you are in the process of applying for services through DDA or RSA, what are the most important things in your life that you would like us to look at?

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* 7. If you have been monitored by Quality Trust, was it:

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* 8. If there is something else you would like us to know, please tell us about it in this space:

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