Addams Student Check-in September 2022

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We want to hear from you! We are here on campus or just an email away ☺ This form will help us know which students need more support. We ask all Addams students to complete the form below. There are no correct or incorrect answers. Thank you!

What is your first name? *

What is your last name? *

What grade are you in? *

6th

7th

8th

What team are you on? *

Princeton

Yale

Harvard

USC

UCLA

Cal

Stanford

Advisory Class Room Number *

Please rate how everything is going for you . *

Struggling a lot

Everything is great

Please select anything below you are struggling with. *

Sadness

Anxiety

Loneliness

Home Concerns (safety, financial, food/ resources)

Recent Death in the Family

Coping with a Terrible Emotional Events (Trauma)

Chromebook, Internet/ Wifi, technology

Class Assignments (Difficulty understanding)

Nothing- I'm doing well!

Required

Do you identify as something other than the gender you were assigned at birth?

Yes

Clear selection

Do you have a safety concern (self-harm or being harmed) about any of your friends or classmates at this time?

Yes

Clear selection

Submit

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