* 1. Please check who you are in relation to the school.

* 2. Please indicate the appropriate grade level (students only).

* 3. Various School Counseling services are listed below. Please read through the list and rate the importance of each service. (1 is least important, 4 is very important)

  Least Important Somewhat Important Important Very Important
Individual Counseling
Small Group Counseling
Classroom Guidance
Community Agency Referrals
Transition Services (elementary to high school, new students)
Special Education Services
Testing (CRT, ACT, ASVAB, etc.)
Reporting Abuse/Neglect
Teacher Consultation (grades, behavior, social situations)
Parent Consultation (grades, behavior, social situations)

* 4. Please list below other counseling services you feel are important at our school.

* 5. Please choose the top 5 topics below that you feel need to be addressed in the school.

* 6. Comments:

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