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Marching Band 'Temperature Check' for 12/11-12/19
Please complete this brief questionnaire. It is important that you answer each question honestly and in full. This information will be kept confidential. As always if you have any questions or concerns, please reach out to Mr. Schlaeger or one of the Band Directors.
If you or someone you know need immediate support, please refer to the resources below and connect with a trusted adult.
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* Indicates required question
Name:
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Your answer
Today's Date
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MM
/
DD
/
YYYY
Today I am (check all that apply)
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Happy
Excited
Sad
Anxious
Tired
Lonely
Bored
Overwhelmed
Other:
Required
Give a few details as to why you feel that way.
*
Your answer
What are you looking forward to (before Winter Break)
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Your answer
Are there any challenges you are facing this week (again - does not have to be band-related) ?
Your answer
After attending the Rose Bowl Overview meeting this past Wednesday, are you having any concerns about the upcoming trip (this can be performance-related or something else)?
Your answer
Is there anything we can do to further support you at this time?
*
Your answer
"It would be helpful if the following checked in with me." (Check all that apply)
We will do our best to meet with you in the upcoming week. You may also email the person.
Principal (Dodd)
Administrator (Drake, Powell, Distel, Rompies, Spitzmueller)
School Counselor (Pay, Dumstorff, Bell, Clark, Brinkman, Affatato, Hicks, Johnston, Rutowski)
School Psychologist (Kramer, Schlaeger)
School-Based Therapist (Flynn, Stratton, Maiorana)
Mental Health Consultant (Marcelle)
Other:
I have concerns about a peer/friend and need some advice on next steps
Your answer
As always, please refer to these resources for additional help.
Hotline Numbers:
Warren County Crisis Line: (877) 695-6333
National Suicide Prevention Hotline: 1-800-273-8255
National Text Hotline: Text HOME to 741-741
Safe Schools Tipline:
Text or Call: 513-972-4910
Email: 1059@alert1.us
App: Safe Schools Alert
Website: https://mason-oh.safeschoolsalert.com/
(Use code:1059)
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I've completed my Temperature Check!
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