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Ms. Dominique wants to know how you are doing! :-)
Check-in with Ms. Dominique! I would love to hear how you are doing!
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What is your first and last name?
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Your answer
Grade Level
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Choose
Pk/K
1st
2nd
3rd
4th
5th
Parent :-)
Teacher :-)
Homeroom Teacher
Your answer
Today I am feeling...
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Happy
Sad
Scared/Shocked
Angry
Confused
Anxious/Nervous
Bored
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What is one thing that you've done today or this week that you've enjoyed?
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Your answer
Did you have any problems today?
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Yes
No
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Did you have to use a calming down strategy to help you feel better?
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Yes
No
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If so, what calming strategy did you use?
Choose
Take deep breaths
Draw a picture
Counting backwards
Listen to music
Talk about it
Read a book
Color a picture
Use a stress toy
Complete a puzzle
Other
After using that strategy, how did you feel?
Not better at all
1
2
3
4
5
Much better
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Would you like to chat with Ms. Dominique?
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No
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If you answered yes, what is the best way to reach you?
Classroom
Email
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