A Place of Our Own Clubhouse Your comments are important to us. Please take a moment to fill out this survey. How strongly do you agree or disagree with each of the following statements? OK Question Title * 1. I like the services that I receive. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 2. I have access to the program during times other than usual work day hours including evenings, weekends, and holidays. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 3. I have access to all of the program activities. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 4. I am able to make my own schedule. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 5. I am a part of all of the decisions made at the program. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 6. I work side-by-side with staff to accomplish tasks and activities in the program. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 7. I actively participate in (scheduled) planned program activities and am able to choose what I want to do. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 8. I feel the work and activities I do in the program are meaningful/ significant. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 9. I receive educational services/ resources/supports in the program. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 10. I receive employment services/ resources/supports in the program. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 11. I have opportunities to give and receive support locating community resources. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 12. I have opportunities to participate in activities that promote my physical well being. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 13. I deal more effectively with daily problems. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 14. I am better able to establish and maintain positive relationships. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 15. I am better able to deal with crisis. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 16. I am developing a better self-image. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 17. I feel more optimistic (hopeful) about the future. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 18. I feel connected to the community through the activities provided by the program. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 19. I am managing my symptoms better. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree OK Question Title * 20. The comments I want to make about the program and services I received are: OK DONE