Stoller MS Family Survey
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Family Member Name
Student Name
Best Method to Follow Up if Needed
Overall, rate your family's current status from 1 (overwhelmed and stressed) to 5 (great and secure).
Overwhelmed/Stressed
Great/Secure
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The pandemic has highlighted the importance of recognizing that mental health is just as important as physical health. Mental health changes may look like a change in sleeping habits, appetite, or motivation, excessive worrying/fear, or changes in school performance. The school has mental health specialists available for our students that can provide short-term counseling or refer them to an outside agency. Is this something you are interested in?
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Would your family like support with any of the following community resources/topics? A staff member may follow up with additional information.
Any additional information or concerns can be added below. Please keep your responses within the subject matter of the survey. This survey is meant to learn more about how families/students are adjusting to this school year and connecting to community resources.
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