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Student Survey
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Email
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Your email
My name is:
Your answer
I prefer to be called:
Your answer
I live with:
Your answer
Things I like to do for fun are:
Your answer
I am really good at:
Your answer
I work best:
alone
with a partner
in a group
it depends on the assignment
Clear selection
Some things that help me learn best are:
Your answer
When I need a break, things that make me feel better are: (select as many as you would like)
Talking with someone I trust
Going for a walk
Relax in a quiet/dark space
Watching a video
Listening to music
Moving my body/exercise
Writing (journaling, making lists, writing a letter)
Reading a book
Playing with a fidget
Drawing/coloring
Playing an instrument
Deep breathing/meditation
Using playdough, putty, or kinetic sand
Using a weighted blanket/lap pad
Swinging
Calming Scents
Touching something soft (animals, fabrics, etc.)
Playing a game
Blowing bubbles
Other:
Something I am excited about for this school year is:
Your answer
Something I am nervous/wondering about this school year is:
Your answer
Something else you should know about me is:
Your answer
A question I have for you is:
Your answer
Send me a copy of my responses.
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