If you are completing this about someone else, please let us know your relationship with them at the end of the survey.  

I am satisfied with Community Services.

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* 1. I am satisfied with Community Services.

I enjoy the staff who work with me.

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* 2. I enjoy the staff who work with me.

I get to do things that are important to me.  

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* 3. I get to do things that are important to me.  

I wish there were more consistency in staff for my services.

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* 4. I wish there were more consistency in staff for my services.

I know the proper people to contact if I have questions or concerns about my services.  

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* 5. I know the proper people to contact if I have questions or concerns about my services.  

I have a voice on places I want to go and things I want to do.  

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* 6. I have a voice on places I want to go and things I want to do.  

Staff help me be involved in my community.  

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* 7. Staff help me be involved in my community.  

I feel like staff listen and respect me.  

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* 8. I feel like staff listen and respect me.  

I am satisfied with my living arrangements.  

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* 9. I am satisfied with my living arrangements.  

I am satisfied with my daily activities.  

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* 10. I am satisfied with my daily activities.  

I feel safe when I am with my staff person.  

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* 11. I feel safe when I am with my staff person.  

Staff help me with being healthy in various ways including appointments, going to the gym, eating healthy, and making good choices. 

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* 12. Staff help me with being healthy in various ways including appointments, going to the gym, eating healthy, and making good choices. 

My three favorite things to do are:

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* 13. My three favorite things to do are:

Person completing survey is self or other (please list relationship if other).

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* 14. Person completing survey is self or other (please list relationship if other).

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