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* 1. Please check one:

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* 2. Please indicate the appropriate grade level:

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* 3. Various school counseling services are listed below.  Please rate the importance of each service.  (1 is least important, 4 is very important)

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

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* 4. Please rank the following topics.  (with 1 being most important, and so on)

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* 5. Comments:

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