Quality of Life Survey

Quality of Life Questionnaire

Purpose and Meaning

Setting your own direction and having a life of meaning
1. I know my own strenghts
2. I think my life has meaning
3. I think that my strengths are used in the community
4. I think my community supports me
5. I think I have the tools I need to have a good life
6. I think the people around me support my life goals

Freedom

Taking charge of your own life, being in control and making decisions.
8. I think I have control over my life
9. I feel heard by people around me
10. I know I can try different options
11. I have the ability to make my own decisions

Money

Having enough money to live well and pay your own way.
13. I am able to earn enough to live a good life
14. I have enough money to pay my bills
15. I am able to save money
16. I can use my money how I choose
17. I think I can manage my own money
18. I think my money is managed well

Home

Having a place where you belong, a place to call home, to relax and be able to be exactly who you are.
20. I feel safe in my home
21. I can live in my home as long as I like
22. I have privacy in my home
23. I live where I want to live
24. I live with people that I like
25. I feel like I belong in my home
26. I can invite people to my home

Help

Giving and getting help from others without giving up your quality of life.
28. I am respected at home
29. I feel respected at work
30. I feel respected in my community
31. I can ask for help when I need it
32. I can change my mind and feel supported if I do
33. I think I have the chance to learn new things
34. I have chances to help other people
35. I speak up for others
36. I vote

Life

Giving and getting help from others without giving up your quality of life.
38. I have the chance to have fun in life
39. I can work or give back to my community
40. I can join community groups
41. I get to spend time with people I like
42. I have energy to enjoy life
43. I control what happens in my life

Love

Having friends, family – loving and being loved
45. I know and respect myself
46. I can make new friends
47. I have or want a partner or lover
48. I have or want a family of my own
49. I give love to others
50. I found this easy to complete
51. These questions were relevant to my life

Submission

53. How long did this take you?