I feel comfortable going to the counseling office for academic concerns.
Strongly Agree
Agree
Somewhat Agree
Somewhat Disagree
Disagree
Strongly Disagree
I feel comfortable going to the counseling office for personal concerns.
Strongly Agree
Agree
Somewhat Agree
Somewhat Disagree
Disagree
Strongly Disagree
I feel comfortable going to the counseling office for concerns about another student.
Strongly Agree
Agree
Somewhat Agree
Somewhat Disagree
Disagree
Strongly Disagree
I knew who the school social workers were before today’s assembly.
Yes
No
I know what the school social workers do.
Yes
No
I can identify at least one staff member who deeply cares about me and my success.
Yes
No
I am involved in a school club, team or activity outside of class.
Yes
No
If yes, I feel my participation in this club, team, or activity has been a positive experience.
Strongly Agree
Agree
Somewhat Agree
Somewhat Disagree
Disagree
Strongly Disagree
I like coming to school.
Strongly Agree
Agree
Somewhat Agree
Somewhat Disagree
Disagree
Strongly Disagree
I would like support with (check any that apply):
Managing my stress
Fitting in at school
Relationship Issues
Bullying Issues
Depression or Anxiety
Grief or Loss
My Anger
Motivation in School
Getting Along with Adults
Identifying Who I Am
Nothing at this time.
I would be interested in participating in a student support group for help in the areas I have identified.
Yes
No
I would like help with substance/alcohol abuse issues.
Yes
No
I feel safe at school.
Strongly Agree
Agree
Somewhat Agree
Somewhat Disagree
Disagree
Strongly Disagree
I have considered dropping out of school.
Yes
No
I would like help with (check any that apply):
Scholarship Options
College Application Process
Career Options
Test-Taking
Options After High School
Nothing at this time
I am happy with my academic success.
Strongly Agree
Agree
Somewhat Agree
Somewhat Disagree
Disagree
Strongly Disagree
I am dealing with a personal or academic issue that I feel the counseling department could support me with, but I have not gone there for support.
Yes
No
If your answer to the previous statement was "yes", please select your reason for not seeking support.
Social Pressure
I don't want to miss class.
I'm afraid my parents will get involved.
I am unaware of how to access the counseling office.
I am afraid of getting in trouble.
I am uncomfortable talking about the issue.
After today, I am likely to seek out support from the counseling department for a personal or academic issue.
Yes
No
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