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* 1. Do you feel the individual gets along with his/her job coach?

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* 2. Do you feel the individual is satisfied with the help that the job coach gives?

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* 3. Do you feel the individual feels included when decisions are made about his/her job?

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* 4. Do you think the individual feels the job coach assist in developing and maintaining work relationships?

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* 5. Do you think the individual feels safe at work?

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* 6. Is he/she happy with the number of hours they work?

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* 7. Are they happy with the time of day they work?

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* 8. What is the duration of the individual's current employment?

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* 9. Do you feel the individual is paid enough?

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* 10. If given the choice, the individual would do the following:

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