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Family Check-In
We want to know how you are doing and the best way to support you and your child(ren) during this time. Please take some time to fill out this quick survey. Thank you in advance for your help with this.
Dr. Dix and Mrs. Dougherty
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* Indicates required question
Name of Person Completing the Survey
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Your answer
Name(s) of Students Who Attend Cold Water
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Your answer
How are you and your family doing? Check all that apply.
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We are doing well.
We are doing ok. Thankful we are not sick.
We have sick family members, but we are doing ok.
We are not doing well at all, either physically or emotionally, and would love some help.
Please call us. We would like to talk.
Other:
Required
How is the new online schooling going?
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Going well
We are having issues. If you are having issues, please explain below
Other:
Optional: Describe your specific concern/s with regard to online schooling.
Your answer
We are struggling with . . . Check all that apply.
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Technology
Completing Work from School
Communicating with teachers and school staff
Household necessities (i.e., food, paper products, personal hygiene items, etc.)
Staying organized
Childcare
We are going stir crazy! We need ideas on how to keep the kids occupied.
Required
On a scale of 1-10 how are your doing emotionally (10 being best)
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Not so great
1
2
3
4
5
6
7
8
9
10
I am doing great
Coping: During this time, it's helpful to find self-care strategies that work for you and your family. Are you using any of the following strategies at this time? (Check all that apply.)
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Sticking to routines as much as possible
Going outside for fresh air
Staying connected with others through digital means
Listening to music
Limiting exposure to news media
Practicing social distancing
Excercise
Spending quality time with family
I would like to learn more about self-care/coping strategies
Other:
Required
I wish the school would . . .
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Your answer
Any thing else that you would like us to know about?
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Your answer
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