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Cheetah Check-In
Tell me how things are going!
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* Indicates required question
My name is....
*
Your answer
My teacher is....
*
Your answer
How are you?
Terrible
Ok
Good
Great
Clear selection
How are things at SCHOOL?
Terrible
Ok
Good
Great
Clear selection
How are things at HOME?
Terrible
Ok
Good
Great
Clear selection
What feelings are you having the MOST right now?
Excited/Happy
Worried/Nervous
Scared/Afraid
Calm/Peaceful
Other:
What is the HARDEST part of working and learning FROM HOME? (Check all that are true for you)
Being distracted by my brother or sister
I don't understand the work
I have no one to help me
I have too much to do- I have other responsibilities and jobs at home
I don't get to see my friends
I don't get to see my teachers
What is the BEST part of working and learning FROM HOME? (Check all that are true for you)
It was quiet and calm
I could do it whenever I wanted to
I have someone at home to help me
I could take my time
I felt safe at home- I wasn't embarrassed or scared
Other:
Do you need your teacher to check-in with you?
NO- I'm doing great! I'll see you in class or online.
MAYBE- I would like to talk to you, but it's not a big deal. It can wait.
YES- I've got an emergency! Something is happening that is dangerous, destructive, or disturbing.
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