Ms. Alegre's Counseling Check-In

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Hello parents and guardians,

I am your child's school counselor and I wanted to check in with my students and their families periodically. If you have any questions or needs, please let me know! You can email me at lucero.alegre@rentonschools.us .

Kindly,

Ms. Alegre

Friends,

Answer as many or as few questions as you'd like. The more, the better! Your answers are private to Ms. Alegre only.

Your name: *

Grade *

Your Teacher

How are you feeling today?

1 - Not good (red face)

2 - Could be better (orange face)

3 - Okay (yellow face)

4 - Pretty good (light green face)

5 - Great (dark green face)

Clear selection

What feeling are you feeling?

What are some things that help you calm down when you have BIG feelings (sad, mad, nervous, scared)?

Deep breathing

Taking a walk

Counting to ten

Talking to an adult you trust

Listening to music

Exercising

Drawing or coloring

Other:

How did you sleep last night?

Didn't sleep at all

Best night's sleep ever

Clear selection

How was your breakfast or lunch?

Didn't eat anything

I'm full

Clear selection

How is everything at home?

Not good at all -- I need a check in.

Home is great!

Clear selection

Do you need a check in call?

Yes

Clear selection

If you need a check in call, what is the best number to reach you at?

Is there anything else you would like to share with Ms. Alegre?

Submit

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