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Blaze Questionnaire

Tell us more about your journey so far for student success!

Please complete the following form as your district prepares to blaze a trail for the whole child. Once received, we will follow up with you to continue the conversation.
1.Please check the appropriate column for your level of interest for each of the items.
Very Interested
Interested
Not Interested
Integrate student health and wellness needs into strategic planning, existing health & wellness committees, and/or student support teams.
Improve coordination of existing supports and services for students and families.
Connect with community agencies, county task forces, education service districts, and state supports to obtain additional resources, supports, and services.
Build/expand upon a system where teachers and staff can refer students and families who needs services or supports.
Develop a K-12 standards-based, skills-focused health education curriculum.
Develop a K-12 standards-based physical education curriculum
Create a trauma-sensitive culture that supports all students’ socially, emotionally and academically.
Provide effective self-care strategies and resources for our educators.
Collect and analyze data to determine student, family, and community needs.
Develop family engagement activities.
Develop/expand upon a multi-tiered system of prevention programs and social emotional student supports that most effectively aligns with our current system
Develop lead, and sustain Whole Child/School Health Councils
Develop skills of the Whole Child/School Health Coordinator
2.Please click on any of the following topics that drive your reasons to engage in the Whole School, Whole Community, Whole Child (WSCC) Approach? (Select all that apply)
3.Please rate your current level of knowledge about the following terms associated with the Whole School, Whole Community, Whole Child
Very Knowledgeable
Somewhat Knowledgeable
Not very knowledgeable/New Concept
Tenets of the WSCC (health, safe, engaged, supported, challenged)
Components of WSCC (e.g. health education, health services)
Policies, programs, and practices
Community Partnerships
Health Services
Behavioral/Mental Health Services
Family Engagement
Equity and Diversity
Whole School Approach
Systems-Thinking 
4.Please rate how you perceive the current level of support for the WSCC approach from each stakeholder group.
Very Supportive 
Somewhat Supportive 
Not Supportive/New Concept 
Administrator
Community Partners
Staff
Community Stakeholders
Families
5.We have incorporated WSCC or a student health goal within our strategic plan.
6.We have a team that meets regularly to discuss the health and well-being of our students.
7.We have conducted a needs assessment and/or collected school or local health data.
8.Our health education curriculum has been updated within the last 5 years.
9.Our physical education has been updated within the last 5 years.
10.We have a referral system where staff can reach out and refer students and/or families who need additional supports/services for health and wellness.
11.We have funding or resources to support our Whole Child goals/initiatives.
12.We have a leader or "Whole Child Liaison/Coordinator" for the district's whole child efforts.
13.Tell us a little more about your goals for the whole child work or anything additional information to help us support your efforts.
14.What is your position?
15.Please list your school district, city and state.
16.Please add your email address.
Current Progress,
0 of 16 answered
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