Student-Family Wellbeing Survey
We care about the wellbeing and safety of our students and our LME families. Ms. Sallie (School Counselor) would like to ask parents about how their kids and their family are doing right now. Your response will be kept confidential. An option to request additional support and resources from Ms. Sallie will be available at the end of the survey. 
Respectfully, Ms. Sallie - LME School Counselor
Sign in to Google to save your progress. Learn more
Family Name:
Student(s) Names *
Student Grade(s)
As a parent, how would you rate Little Mountain Elementary as a safe and positive school for your children to attend?
Clear selection
If Not Good or Terrible, please share how we can improve.
Please use a scale (1-5) to share how your kids are feeling.
5 = Great
4 = Good
3 = Okay
2 = Not Good
1 = Terrible
How does your student(s) feel about coming to school most days?
Captionless Image
Clear selection
If Not Good or Terrible, please explain.
How does your student(s) feel about their teacher(s) this year?
Captionless Image
Clear selection
If Not Good or Terrible, please explain.
How does your student(s) feel about their schoolwork?
Captionless Image
Clear selection
If Not Good or Terrible, please explain.
How have your student(s) friendships been at school?
Captionless Image
Clear selection
If Terrible or No Friends, please explain what is going on.
Is your student(s) being Bullied right now?  (Remember bullying is on purpose, again and again. Not a mean moment or two sided conflict.)
Captionless Image
Clear selection
If yes to being bullied and your child is Not feeling safe at school, please explain what has been going on.
How has your student(s) been sleeping at night recently?
Captionless Image
Clear selection
If Not Good or Terrible, please explain.
How has your student(s) appetite been recently? (Appetite is how much you feel like eating) *
Captionless Image
If Not Good or Terrible, please explain.
How are things feeling at home with your family right now?
Clear selection
If Not Very Good or Stressful, you have the option to share with us what is going on so we can support your student(s) and family. Remember that this is confidential.
When your student(s) have big feelings, what 3 activities help them to feel better?
Would you like your student to meet with Ms. Sallie? (School Counselor)
Clear selection
Is there anything else you would like support with right now? Respectfully, Ms. Sallie
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mount Vernon School District #320. Report Abuse
Google Forms