FIVE Student Counseling Program Needs Assessment (Grades 9-12)
Hello! My name is Mrs. Earl and I am so excited to serve as the Secondary School Counselor this year! I would like to determine how to best meet your needs. Please answer the following questions to assist me in planning worthwhile activities during the 2022-23 academic year. Your input will assist me in creating a program designed specifically to address your developmental needs. Thank you!
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School
First Name *
Last Name *
Grade
I need help with the following PERSONAL concerns *
Strongly Agree
Agree
Neither Agree nor Disagree
Disagree
Strongly Disagree
Making Friends
Fitting in School
Dealing with Peer Pressure
Making Better Decisions
Improving Communication
Dating/Relationship Issues
Getting Involved in School Activities
Helping myself (gaining more self-confidence, feeling better about myself, expressing my feelings and thoughts)
Being more Assertive
Feeling Sad or Depressed
Getting along better with peers
Getting along better with family members
Feeling sad or depressed
Grief over the loss of a loved one
Dealing with Anger
Overcoming Stress
Feeling Anxious or Overwhelmed
Concerns about alcohol or drug use
Skills for Resolving Conflict
I need help with the following school concerns *
Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
Being more organized
Managing my time better
Improving study skills
Reducing test anxiety
Improving test-taking skills
Understanding what my test scores mean in relation to academic and career planning
Developing my course schedule
Understanding the best career options for me
Planning my options after high school
The college application process
Understanding my learning style to improve how I learn
Knowing about and applying for scholarships and financial aid
Knowing what educational options are available to me when I graduate
Getting along with teachers
Transitioning to a new school
Understanding graduation requirements
Selecting a career cluster or concentration
Please check how much you agree with the following statements.
Strongly Agree
Agree
Neither Agree nor Disagree
Disagree
Strongly Disagree
I know who my counselor is.
My counselor likes me.
My counselor is available to me when I need to see/him or her.
I feel comfortable going to see my counselor to get help with SCHOOL concerns.
I feel comfortable going to see my counselor to get help with PERSONAL Concerns.
My classes keep me interested in the topic.
I like coming to school.
My teachers are willing to help me when I have questions.
My counselor has met individually with me least once to help me plan my schedule for next year.
The school is involved in my developing my education plan.
My counselor has met individually with me least once to help me understand the relevance of the state assessment and what my scores mean to me.
Someone in the school has regularly helped me plan for my future career.
There is at least one staff member in the school that I believe cares deeply about me and my success
Clear selection
Please check how much you agree with the following statements.
Strongly Agree
Agree
Neither Agree nor Disagree
Disagree
Strongly Disagree
I have a clear career plan to follow when I graduate.
I understand why I take the state assessment.
I am involved in at least one school activity outside of class.
I understand why I need a good education.
I will stay in school until I graduate high school.
I will continue my education after high school.
Clear selection
What are your plans after graduation?
Clear selection
What is/are your Career Goal(s)?
Please list any other concerns or needs that were not mentioned that you would like help with.
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