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* 1. Are you satisfied that your Community Habilitation Plan reflects what you choose to work on in your home and/or community?

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* 2. If community opportunities are built into your Community Habilitation Plan, are you satisfied with your opportunities to access your community?

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* 3. Are you satisfied with how often you receive your Community Habilitation Services?

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* 4. Are you satisfied that Aspire staff effectively assist you with the activities in your Community Habilitation Plan?

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* 5. When you have asked for an improvement, has the agency staff responded in a timely manner to improvements you requested?

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* 6. Were you satisfied with the outcome of the resolution of your request?

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* 7. How can we better support you during your Community Habilitation Services?

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

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