Rush Springs ELEMENTARY Student Needs Assessment 2020-2021
Parents please answer these questions in regards to your child. This survey will help Mrs. Burch learn what kinds of programs we need to offer to support all of our students. PLEASE READ EACH STATEMENT AND MARK THE MOST APPROPRIATE ANSWER CHOICE FOR YOUR CHILD. Please fill out a form for each of your children.
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Student's Name *
Grade *
PERSONAL/SOCIAL/EMOTIONAL  Please mark the following: My child needs help with
Agree
Neutral
Disagree
Making friends
Decision making
Social skills
Family Issues
Divorce/Separation of Parents
Self-Confidence
Conflict Resolution
Anger
Impulse control
Depression/Sadness/Grief
COVID-related concerns
Fear/Anxiety
Stress
Clear selection
ACADEMIC Please mark the following: My child needs help with
Agree
Neutral
Disagree
Time Management/Organization
Study Skills
Test Anxiety
Asking for help
Communicating with teachers
Test-taking skills (standardized and course tests)
Possible Learning Disability
Distance Learning Issues
Clear selection
Is there something not on the survey that you feel your child needs help with?
Who in your child's family has attended a VoTech for training? Check all that apply
Who in your child's family has attended College (Community College or 4 year) for some or all of a degree.  Check all that apply
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