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* 1. How satisfied are you with the current rules and regulations in the group home?

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* 2. Which areas of behavior do you think you have improved in? (Select all that apply)

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* 3. Can you describe any specific actions you have taken to improve your behavior?

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* 4. How often do you follow the group home's rules and guidelines?

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* 5. What additional rights or privileges would you like to earn in the future?

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* 6. What steps do you think you can take to earn these additional rights or privileges?

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* 7. How supported do you feel by the staff in improving your behavior?

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* 8. Do you have any suggestions for the staff on how they can better support you?

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* 9. Please provide your name (optional)

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