Information recorded on this survey will be used to shape and improve our services

* 2. Please enter your name:

* 3. Please enter your address:

* 4. Please enter your telephone number:

* 5. Who is your Independent Living Worker?

* 6. Were you treat with respect and involved with your support?

* 7. Were you happy with the time you spent with your Independent Living Worker?

* 8. Were you involved with designing your Personal Positive Plan?

* 9. Did it help you to achieve your goals?

* 10. Were you happy with the range of opportunities that were available?

* 11. What has changed in your life as a result of using our service?

* 12. Was there anything that you were unhappy with?

* 13. What would you change about the service, and why?

* 14. How would you rate our service (as a percentage) with 100% being the best, and 1% being the worst.

* 15. Can we contact you again in 6 months time to see how you are getting on?

* 16. Do you have any other comments, questions, or concerns?