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* 1. Are you satisfied with the staff providing your services?

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* 2. Do staff members make you feel safe in your home and/or community?

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* 3. Do the staff members providing your services treat you with kindness and respect? 

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* 4. Do you like where you live and who your housemates are (Residential Services)?

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* 5. Do you go places and do things you enjoy?

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* 6. Do you get to visit with friends and people you like? 

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* 7. Do you make choices about how you spend your time? 

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* 8. Are you encouraged to make your own choice about where/what you eat, where you shop, and what you do for fun?

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* 9. Do you choose when and how often your services are provided? 

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* 10. Do your feel that the services provided by skillset have improved  your quality of life? 

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* 11. Would you like to provide your name? 

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