How are you doing today?
I miss seeing each and every one of you at Esqueda! Please check-in and let me know how you are doing. I'm available if you need to chat. -  I miss you!


* Please note these form submissions will be checked daily, If you are a student who is experiencing a mental health crisis, please contact: The SAUSD Mental Health Resource Line: 657-290-9527 (8:00 am - 4:00 pm) or click here for more information: https://www.sausd.us/Page/44001


If this is an emergency please immediately call 9-1-1.
Sign in to Google to save your progress. Learn more
Email *
What is your first and last name? nombre y apellido? *
Captionless Image
What is your ID (lunch number)? ¿Cuál es su identificación (número de almuerzo)?
Grade Level/ Grado *
Captionless Image
Today I am feeling... Hoy me siento... *
Captionless Image
What is one thing you have done today you enjoyed? Que hiciste hoy que difrutaste? *
Captionless Image
Is there something bothering you today? ¿Hay algo que te moleste hoy? *
Captionless Image
If you have a problem today you can use a calm down tool! Which calm down strategies did you use? Please list. Si tienes un problema hoy, puedes usar una herramienta para calmarte! ¿Qué estrategias de calma usaste? Por favor liste
Captionless Image
Would you like to speak with me?b ¿Te gustaría hablar conmigo?
Captionless Image
Clear selection
If you would like to speak to me how would you like to chat? Si quieres hablar conmigo, ¿cómo te gustaría chatear?
Captionless Image
Clear selection
Is there anything else you would like to share? We would like to hear from you! Hay algo más que quieras compartir? Te extrañamos y estamos aquí para ti!
Captionless Image
I look forward to seeing all your faces soon!   -Mrs. Estrada
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of SAUSD Google Apps. Report Abuse
Google Forms