Mindfulness Survey
How often do you get angry and feel out of control? *
Never
Often/ Always
How often do you get stressed out and have trouble calming down? *
Never
Often/ Always
How often do you lose focus and miss information in class? *
Never
Often/ Always
What skills can mindfulness help build?  Choose all that apply: *
Required
How often have you used one of these techniques? *
What are some specific ways you have used mindfulness in school? *
Required
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