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CES Counseling Program Needs Assessment (Parents)
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Grade of Student of Students
PreK
K
1st
2nd
3rd
4th
5th
6th
Child 1
Child 2
Child 3
Child 4
PreK
K
1st
2nd
3rd
4th
5th
6th
Child 1
Child 2
Child 3
Child 4
School counselors can help with many things. For each category below, think about if you child would benefit from working on any of the areas. Select 1 for YES, 2 for MAYBE, and 3 for NO.
This year I would like my child to receive help with:
Learning about him/herself
YES
1
2
3
NO
Clear selection
Feeling good about him/herself
YES
1
2
3
NO
Clear selection
Getting along with classmates
YES
1
2
3
NO
Clear selection
Making new friends and/or keeping friends
YES
1
2
3
NO
Clear selection
Dealing with unkind students
YES
1
2
3
NO
Clear selection
Talking about his/her feelings
YES
1
2
3
NO
Clear selection
Learning to make good decisions
YES
1
2
3
NO
Clear selection
Learning how to study, take tests, and/or set goals
YES
1
2
3
NO
Clear selection
Learning about jobs/careers
YES
1
2
3
NO
Clear selection
Learning new ways to cope with stress
YES
1
2
3
NO
Clear selection
Submit
Clear form
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