Please complete all questions below and submit your survey, your vocational consultant will then discuss your responses.

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* 1. Full Name

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* 2. Consultant Name

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* 3. Enrolled module

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* 4. Please select ONE number against each indicator below to show how satisfied or dissatisfied you are about your life.
(0 = totally dissatisfied - 10 = totally satisfied)

  0 1 2 3 4 5 6 7 8 9 10
Your physical health
Your psychological health
Your sleeping pattern
Your relationship with family and friends
Your feelings of security
Your involvement with your local community
Your employment opportunities
How you use your leisure time
Your financial situation
Your relationship with your partner/children
Your sexuality
Your use of drugs and alcohol

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