Wellbeing questionnaire for children

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My name

My current class

4DW

Clear selection

I feel happy

Not at all

Very much so

Clear selection

I feel brave

Clear selection

I can ask for help if I need it

Clear selection

I am making contact with my friends

Clear selection

I am making contact with my family that I can't be with right now

Clear selection

I am getting some exercise every day

Clear selection

I am coping with my feelings

Clear selection

I can share my feelings with someone

Clear selection

I am helping at home

Clear selection

I am learning new things

Clear selection

I have a routine at home

Clear selection

I am taking a break and relaxing my mind

Clear selection

I am getting a good nights sleep

Clear selection

I like being at home

Clear selection

I feel safe at home

Clear selection

I feel connected to my school

Clear selection

I feel good within myself

Clear selection

I know how to cope with my worries

Clear selection

I am trying my best at everything I do

Clear selection

I am having fun with my family

Clear selection

I am spending some time outdoors every day

Clear selection

I am doing my school work

Clear selection

Is there anything in particular that is worrying you about coming back to school?

Are you happy for us to share this information with school staff so that we can help you feel safe and happy when you come back to school?

Yes

Clear selection

Submit

Clear form

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