Self Advocacy

I am a self advocate...

• All of the time

• Most of the time

• Some of the time

• On rare occassions

• Very rarely, almost never

When confronted with something I don't know...

• I look for answers on my own first, then ask if I still don't know.

• I ask a question right away.

• I'll ask someone I feel comfortable with later

• I'll ask later if I remember.

• I won't ask a question.

How do you feel about the statement below:

By knowing the rules I can better move forward and meet my goals and needs.

• I wholly agree with the statement

• I agree with the statement

• I most agree with the statement

• I disagree with the statement

• I wholly disagree with the statement

Fill in the blank with the choices below:

I have ______ friends and family who support me through thick and thin

• lots

• some

• a few

• hardly any

• none

How strong do you agree/disagree with the following statement:

I can solve any problem with the support of my friends, family, and kumus.

• Strongly agree

• Agree

• Somewhat agree

• Disagree

• Strongly disagree

How strong do you agree/disagree with the following statement:

In process of solving a problem, I try to figure it out on my own then get help from others only if I need to.

• Strongly agree

• Agree

• Somewhat agree

• Disagree

• Strongly disagree

How strong do you agree/disagree with the following statement:

I can take control of my life and meet my goals. I may make mistakes along the way, but I'll do the best I can.

• Strongly agree

• Agree

• Somewhat agree

• Disagree

• Strongly disagree

I would like to improve in the following areas (check all that apply).

• Staying informed and knowing how to get information.

• Knowing my rights and responsibilities

• I want to find people who will support me.

• I want to be more of a problem solver.

• I want to take control of my own life.