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ST Pupil Safety and Wellbeing - Spring 22
This questionnaire is confidential. Please be honest and help us to keep everyone at school safe and happy.
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* Indicates required question
Year group
*
Year 3
Year 4
Year 5
Year 6
Name (if you would like us to know)
Your answer
1. There is an adult in school I can talk to if I have a problem.
*
Yes
No
2a. There is something worrying me at school.
*
Yes
No
2b. If there is something worrying you at school, please explain what it is.
Your answer
3a There is something worrying me at home
*
yes
no
3b If there is something worrying you at home, please explain what it is
Your answer
4a. I am being bullied.
*
Yes
No
4b.If someone is bullying you, please write the details below.
Your answer
5. Are you worried about anyone else at school? Why?
Your answer
6. Do you feel the school rules are applied to all pupils in a fair way?
*
All of the time
Most of the time
Some of the time
Rarely
Not sure
Is there anything else you would like us to know?
*
Your answer
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