The questionnaire will take about 10 minutes to complete.

What to do:

Please tick one answer for each question.

If a question is not about you, then please do not answer it.

If you want to, there is a space for you to write something after each question.

* Your name

Thinking about your life at the moment, do you agree with the following:-

* Q1. I live in a home where I am happy

* Q2. I am happy with the people that I live with

* Q3. I can do the things I like to do

* Q4. I feel I belong in the area where I live

* Q5. I am happy with my family, friends and neighbours

* Q6. I feel safe (for example cared for and safe from anyone who can hurt you or treat you badly, both inside and outside your home).

Thinking about the care and support you have had, do you agree with the following:

* Q7. I know who to speak to about my care and support

* Q8. I have had the right information or advice when I needed it

* Q9. My views about my care and support have been listened to

* Q10. I have been able to use my everyday language (for example using English, Welsh, Polish, Bengali or any other language)

* Q11. I was treated with respect

* Q12. I am happy with the care and support I have had

If you are 16 or 17 years old, please answer question 13.  If not, go to question 14.

* Q13. I have had advice, help and support that will prepare me for adulthood

A little about you ...

* Q14. Are you?

* Q15. How old are you?

Thank you for your help.