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School Counseling: Parent/Guardian Needs Assessment 2021-2022
Thank you for taking this short survey! We will use this data to help inform our programs. Names will be kept confidential. Contact us anytime at 261-5060 ex 4.
- Ms. Bushey & Ms. Witter
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* Indicates required question
Please share your name if you are comfortable doing so:
Your answer
Please choose the grade level(s) of your student:
*
K
1
2
3
4
5
Required
What is the greatest area of need for your student(s) overall?
*
Attendance
Behavior (inculding focus and engagement)
Academics
Social & Emotional Needs
Other:
Required
I understand what a school counselor does.
*
Not at all
1
2
3
4
5
Very much
I feel comfortable reaching out to a school counselor to discuss my child.
*
Extremely Uncomfortable
1
2
3
4
5
Very Comfortable
My child could most benefit from help with the following topics (choose all that apply):
Anxiety or Stress Management
Appropriate use of social media
Conflict Resolution
Coping Skills
Emotional regulation
Family issues (divorce, death, incarceration, siblings, new baby, etc)
Friendship
Motivation
Making Good Choices
Self-control
Self-esteem building
Social Skills
Study Skills/Organization/Time Management
Other:
I would like to attend a parent workshop on the following topics (check all that apply):
*
Anxiety or Stress Management
Appropriate use of social media
Conflict Resolution
Coping Skills
Emotional regulation
Self-esteem building
Social Skills
Study Skills/Organization/Time Management
I am not interested.
Other:
Required
The best time of day for me to attend a workshop is:
*
Morning
Afternoon
Evening
I would prefer a parent workshop to be
*
In-person
Virtual
I would like for my child to meet with a school counselor one on one. Here is my child's name and a bit about what is going on. I understand a counselor will contact me to discuss further.
Your answer
I would like for my child to be in a small counseling group. Here is my child's name and what I would like the group to focus on. I understand a group may not be created right away, and that a counselor will contact me to follow up.
Your answer
Is there anything else you would like to share about your student(s)' needs at this time?
Your answer
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