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Counselor Check-In
Let Ms. Yan know how you're doing and if you need a check-in.
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Student's Name:
*
Your answer
Teacher:
*
Your answer
Email Address:
*
Your answer
Phone Number:
Your answer
How are you doing?
*
Really Struggling
Somewhat Struggling
Okay
Pretty Good
Great
What is the hardest thing about being home?
Your answer
What is the best thing about being home?
Your answer
I would like some help with... (if other, please specify)
Strategies and routines to get my child to do their school work.
Emotional support for my child and/or family.
Finding resources in the community.
Other:
Would you like Ms. Yan to check-in and contact you?
*
Yes
No
If yes, please let me which days, time, and best ways to contact you (email, phone, or text).
Your answer
Parents or Students: Please leave any questions you have for the school or staff below.
Your answer
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