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Student Needs Survey SY 23

Thank you for taking this short survey.  We are interested in the health and well-being of students attending Hope Institute Learning Academy and their families.  Your answers will help us plan programs at the UIC-Hope Health & Wellness Center, right here in your school.  Your answers will also help us make sure that we work with you in the best way.  The survey will take 5-10 minutes to complete.  

If you have any questions, about the survey or would like information about the results, please contact Sheila Harmon at 312-996-4656.  A full report will be sent to the principal and to the Local School Council to share with the whole school community.  Again, thank you for taking this survey.

Please answer each question by checking the box next to your answer. There are no right or wrong answers to any question. This information is confidential:  your name will not be included in your answers. 

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* 1. Have you been to a doctor or nurse in the past 12 months?

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* 2. Have you ever gotten sick while at school?

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* 3. If you said yes, what happened?

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* 4. Have your been to the dentist in the past tweleve months?

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* 5. What are some of the problems that you have?  (Check all that apply)

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* 6. What are some of the health problems that your friends other students in your school have?  (Check all that apply)

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* 7. What are some of the problems you, your friends, or other students at this school have?  (Check all that apply)

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* 8. In your opinion, what are some strengths of the students in this school? (Check all that apply)

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* 9. Have you ever tried to get tested for COVID-19?

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* 10. If yes, were you able to find a convenient place to get tested?

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* 11. To your knowledge, do you have, or have your ever had a positive test for COVID-19?

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* 12. If "Yes", describe the level of care you received, or are receiving?

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* 13. Do you personally know anyone in your family, group of friends, or community who became seriously ill or died as a result of COVID-19?

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* 14. Have you received a COVID-19 Vaccine?

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* 15. Do you or your parents plan on getting the COVID-19 Vaccine?

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* 16. Did you know that you, or your family members, and friends who are eligible for the COVID vaccine, can get it at the school health center free of charge?

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* 17. What are the things that you like most about your life?

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* 18. Whom do you live with most of the time?

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* 19. When you have problem, what adults can you talk to?

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* 20. Do you think of yourself as

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* 21. Do you think of yourself s: (check all that apply)

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* 22. How old are you?

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* 23. What is your Zip code?

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* 24. Is there anything else you would like for us to know?

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