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CV Schools Parent and Community Wellness Survey
Please complete one for each school your child attends
Please check the school your child attends
On most school days, does your child: (check one)
Required
How often does your child buy snacks (a la carte) from the school's lunch line (6th - 12th grades)
Required
General Wellness Issues:
How important is it for your child to have enough time to eat lunch?
Required
How important is it that your child have a pleasant place to eat lunch?
Required
How important is it that your child have the opportunity to earn rewards other than food (i.e. Books, extra recess time, certificates, etc.) for his/her accomplishments?
Required
How important is it that your child have available health education in school?
Required
How important is it to have an adult at school to talk to about health concerns and issues?
Required
How important is it that parents receive education/information at home regarding sound nutrition?
Required
How important is it that parents receive education/information at home regarding physical activity?
Required
Food and Nutrition Issues: How important are the following to you?
My child being able to get a healthy breakfast at school
Most Important
Not very important
My child being able to get a healthy lunch at school
Most Important
Not very important
My child being able to get healthy snacks at school
Most Important
Not very important
My child being able to get healthy snacks during after school activities
Most Important
Not very important
Having high quality/good tasting food choices in the cafeteria
Most Important
Not very important
Having high quality/good tasting food choices during after school activities
Most important
Not very important
The school encouraging my child to make healthy food choices
Most Important
Not very important
Nutrition standards for all foods/beverages sold on school campuses
Very Important
Not very important
Nutrition standards for all foods/beverages brought to class/school (eg. rewards, parties)
Very Important
Not very important
Physical Activity: How important are the following to you?
My child having a variety of opportunities to be physically active during the school day
Required
Teachers integrating physical activity into classroom activities
Required
Daily recess
Required
Daily Physical Education
Required
After school physical activity opportunities at school
Required
How many minutes a day do you think should be devoted to the following activities?
Lunch
Required
Physical Education
Required
Health Education
Required
Recess
Required
How many days a week do you think students should be exposed to the following subjects?
Nutrition Education
Required
Comprehensive Heath Education
Required
Physical Education
Required
Are you aware of the menus offered in our school breakfast program?
If yes to the above question, how satisfied are you with the offerings?
Very Satisfied
Unsatisfied
Are you aware of the menus offered in our school lunch program?
If yes to the above question, how satisfied are you with the offerings?
Very Satisfied
Unsatisfied
Please check which foods you feel appropriate for classroom parties, celebrations or rewards.
What types of snacks would you like to see in the vending machines
What is the top thing your school could do to improve student nutrition and wellness?
Your answer
What one thing could your school do to promote student physical activity and fitness?
Your answer
In what way would you be willing to participate or volunteer to improve school wellness?
Your answer
Thank you for your participation!
Parent Name (optional)
Your answer
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