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Daily Check-In Form
Good morning/afternoon! Tell me how you are feeling today!
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Period (choose one)
*
Choose
Period 2a
Period 2b
Period 3a
Period 3b
Period 4a
Period 4b
Period 5a
Period 5b
Assigned Seat Number
*
Your answer
How did you sleep last night?
*
Didn't sleep at all
1
2
3
4
5
Best sleep ever!
How was your breakfast (P. 2/3) or lunch (P. 4/5)?
*
Didn't eat breakfast/lunch
1
2
3
4
5
Best breakfast/lunch ever!
Pick the emoji that best matches your mood today.
*
Option 1
Option 2
Option 3
Option 4
Option 5
Option 6
Option 7
Option 8
Option 9
In general, how are things outside of class?
*
Horrible :(
1
2
3
4
5
Best day of my life!
Anything I need to know? (optional)
Your answer
If you were LATE to this class please explain why (if you were not late leave blank).
Your answer
If you were ABSENT last class please explain why (if you were not absent leave blank).
Your answer
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