HCHS 21st CCLC Needs Assessment Survey
Email *
Teen Health Issues that Interfere with Learning *
Not A Concern
Minor Concern
Major Concern
Abuse/Neglect
Community Violence
Eating Disorders
Homelessness
Lack of Basic Needs
Lack of Sleep
Lack of Vision Care
Mental Health
Obesity
Poor Health Care
Poor Nutrition
Substance Abuse
Teen Awareness Education Needs *
Not a Concern
Minor Concern
Major Concern
Alcohol
Anger Management
Counseling Services
Dating Relationships
Drugs (other than Alcohol)
Financial Management
Mental Health Skills
Phone/Cyber Addiction
Self-Help Skills
Tobacco Use
Vaping
Teen Social & Emotional Issues that Interfere with Learning *
Not a Concern
Minor Concern
Major Concern
Abuse or Neglect
Anger Issues
Anxiety/Depression
Bullying/Intimidation/Violence
Divorce
Lack of Basic Needs
Lack of Family Support
Loss/Grief
Peer Pressure
Self Esteem/Image
Social Skills
Suicide/Self Harm
Teen Transition Needs when Exiting High School Needs *
Not a Concern
Minor Concern
Major Concern
Career Exposure
College Visits
Communication Skills
Employability Skills
Financial Literacy
Leadership Development
Organizational Skills
Scholarships
Time Management
Transition Programs
Educational Programming Needs  *
Not a Concern
Minor Concern
Major Concern
ACT/SAT Test Prep
Credit Acceleration
Credit Remediation
Homework Help
Literacy Skills
Math Skills
Science/Technology Skills
Writing Skills
Please provide and explain any additional needs/concerns you feel teens have that the 21stCCLC program could address.
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