Community Adult Response

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* 1. How old are you?

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* 2. Do you participate in weekly activities with other people (not including your job or school)? Which ones do you enjoy?

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* 3. How often do you do things with other people (not including your job or school)?

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* 4. Which of the following activities would you enjoy?

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* 5. Do you have a job? If so, where and how often do you work?

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* 6. Do you currently live independently (not with your family)?

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* 7. If you aren't living independently, would you like to?

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* 8. If you are living independently, do you have a roommate or apartment mate?

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* 9. Where do you currently live (which town or city)?

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* 10. If you were to live independently, would you want to live with other people (roommates or apartment mates)?

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* 11. Which of the following places would you like to live? You can choose more than one.

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* 12. If you want to live independently, which of the following supports might you need (you can choose more than one)?

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