Silver Hills Middle School Parents Needs Assessment
The Counseling Department at Silver Hills would like your help in determining priorities for student, staff, and parent services. Please take a few minutes to fill out this brief survey. The results are used to plan for the 2015-2016 school year. Thank you.
* Required
Parent First and Last Name (optional)
Your answer
1. Please indicate the current grade level of your student
*
6th Grade
7th Grade
8th Grade
2. Please indicate your ethnicity
*
African American
Asian
Hispanic or Latino
American Indian
Caucasian
Other:
3. Various school counseling services are listed below. Please read through the list and rate the importance of each service.
*
Not Important
Somewhat Important
Important
Very Important
Bullying Prevention
Reporting Abuse and Neglect
Post Secondary Planning
Transition Services (elementary to middle, middle to high, and new students)
Individual Counseling
Community Agency Referrals
Crisis Intervention
Classrooom Guidance Lessons
Peer Mediation
Small Group Counseling
Academic Support Skills
Parent Consultation (grades, behavior, personal/social situations
Not Important
Somewhat Important
Important
Very Important
Bullying Prevention
Reporting Abuse and Neglect
Post Secondary Planning
Transition Services (elementary to middle, middle to high, and new students)
Individual Counseling
Community Agency Referrals
Crisis Intervention
Classrooom Guidance Lessons
Peer Mediation
Small Group Counseling
Academic Support Skills
Parent Consultation (grades, behavior, personal/social situations
4. Please list other counseling services below that you feel are important to offer to students at Silver Hills which were not listed above.
Your answer
5. Please read through the following list of concerns and check areas which you believe YOUR STUDENT'S needs are.
*
Low self-esteem
Alcohol/Drug use
Poverty/Homelessness
Divorce
Stress/Anxiety
Eating Disorders
Anger Management
Neglect/Abuse
Improving school success (time mangement, organization, study skills, etc.)
Positive relationships (peers, family, teachers, dating)
Bullying/Harassment
Self Harm/Cutting
Gender Identity/Sexual Orientation
Motivation
Goal Setting
Grief and loss of a loved one
Depression/Talking about suicide
Impulsive/Hyperactive behaviors
Other:
6. Please read through the following list of concerns and check areas which you believe YOUR STUDENTS' PEERS needs are.
*
Low self-esteem
Alcohol/Drug use
Poverty/Homelessness
Divorce
Stress/Anxiety
Eating Disorders
Anger Management
Neglect/Abuse
Improving school success (time mangement, organization, study skills, etc.)
Positive relationships (peers, family, teachers, dating)
Bullying/Harassment
Self Harm/Cutting
Gender Identity/Sexual Orientation
Motivation
Goal Setting
Grief and loss of a loved one
Depression/Talking about suicide
Impulsive/Hyperactive behaviors
Other:
7. Which of the following parent nights would you be interested in attending?
*
Bullying Prevention
Self Harm/Cutting
Internet Safety
Post-Secondary Planning
Other:
8. When should the parent education workshops be offered? (Please specify days and times that would work best for you)
Your answer
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