Thank you for taking our needs assessment survey. We appreciate your feedback as we strive to meet the needs of our students.

* 1. Please check the answer that best describes you:

* 2. Please indicate your child's grade level (choose all that apply)

* 3. Various school counseling services are listed below. Please read through the list and rate the importance of each service (1= Least Important, 4= Very Important).

  1. Least important 2. Somewhat important 3. Important 4. Very important
Personal Crisis Assistance
Small Group Counseling
Classroom Guidance
Community Agency Referrals
Transition services (elementary to middle school; middle to high school; etc.)
Testing (MAP, STAR, DRA, EOC, ACT)
Reporting Abuse/Neglect
Teacher Consultation (grades, behavior, social situations)
Parent Consultation (grades, behavior, social situations)

* 4. Please rank the following topics, 1-18, as you would like to see them addressed, 1 being the most important and 18 the least important.

* 5. I know where to go to:

  Yes No
Locate a food bank
Apply for food stamps
Find childcare
Open an assistance case with family services
Receive immunizations
Receive assistance for clothing/personal items
Find dental assistance
Seek help for pregnancy

* 6. Have you and your family ever been considered homeless?

 
Yes
No

* 7. If you and your family have ever been homeless did you, or do you now, know where to find assistance?

* 8. Do you have any other comments, questions, or concerns?

T