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Guidance Counseling Needs Assessment 2019-2020 (Grade 7)
Check "Yes" to all items that are concerns for you or items that you would like more information about. Check "No" to all items that ARE NOT concerns for you.
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* Indicates required question
Making friends
*
Yes
No
Fitting in at school
*
Yes
No
Dealing with peer pressure
*
Yes
No
Rumors or gossip
*
Yes
No
Eating disorders
*
Yes
No
Skipping school
*
Yes
No
Concerns about alcohol and/or drug use with self or family
*
Yes
No
Fearful of making mistakes
*
Yes
No
Handling teasing or being bullied
*
Yes
No
Conflict resolution (solving issues with friends)
*
Yes
No
Goal setting
*
Yes
No
Family Relationships
*
Yes
No
Feeling sad or depressed most of the time
*
Yes
No
Hurting/cutting yourself
*
Yes
No
Thinking/talking about suicide
*
Yes
No
Grief over the loss of a loved one (family or friend)
*
Yes
No
Parental divorce, separation, or change in the family
*
Yes
No
Difficulties with controlling your anger
*
Yes
No
Feeling stressed/anxious
*
Yes
No
Being more organized
*
Yes
No
Test anxiety
*
Yes
No
Issues getting along with teachers
*
Yes
No
Feeling like you do not have a trusted adult in the building to talk to about problems
*
Yes
No
Feeling unsafe at school
*
Yes
No
Asking for help
*
Yes
No
Are you interested in being in a social-emotional small group?
*
Yes
No
Any Additional Comments:
Your answer
Name (used only to create a group or to help you):
*
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