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15
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1
日期
*
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Date
日
月
年
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2
姓名
*
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3
调查类别
*
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接受协助的初期
接受协助的中期
接受协助的后期
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4
问卷打分量表:
0 = 非常不满意 至 10 = 非常满意
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5
与生活总体满意度相关的问题:
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6
评估生活和个人情况, 您对生活总体的满意度是?
*
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0
1
2
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7
8
9
10
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7
个人幸福指数相关的问题:
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8
您对生活水平的满意度是?
*
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0
1
2
3
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6
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8
9
10
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9
您对健康的满意度是?
*
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0
1
2
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8
9
10
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10
您对人生成就的满意度是?
*
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0
1
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8
9
10
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11
您对人际关系的满意度是?
*
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0
1
2
3
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6
7
8
9
10
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12
您对人身安全的满意度是?
*
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0
1
2
3
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7
8
9
10
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13
How s您对您社会融入归属的满意度是?
*
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0
1
2
3
4
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6
7
8
9
10
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14
您对未来安全感的满意度是?
*
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0
1
2
3
4
5
6
7
8
9
10
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15
谢谢您抽出时间填写这份调查
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