Student Back to School Survey 2016-17
The school counseling department wants to make sure that we plan and create programs that meet your needs. Please answer the following questions to let us know what concerns you have in your life at school and at home. Please be totally honest in your answers. Only you will know the answers you provide since we do not ask for your name.
I need help with the following PERSONAL concerns:
Fitting in at school
Dealing with peer pressure
Self-confidence/feeling better about myself
Handling teasing or being bullied
Getting along better with other students
Getting along better with family members
Feeling sad or depressed
Grief over the loss of a loved one
Parent divorce or separation
Concerns about alcohol/drug use
I need help with the following SCHOOL concerns:
Adjusting to school
Being more organized
Managing my time better
Improving my study skills
Understanding the best career options for me
Planning for high school
Reducing test anxiety
I feel comfortable going to my counselor to discuss PERSONAL concerns.
I feel comfortable going to my counselor to discuss SCHOOL concerns.
I like coming to school.
My teachers are willing to help me when I have questions.
I understand why education is important for my future.
I plan to stay in school until I graduate.
When I finish school, I would like to be (career):
I feel safe/comfortable at school.
My classmates treat me with kindness and respect.
I believe that bullying is a problem at Holbrook.
I have witnessed students at Holbrook being bullied:
What grade are you in?
OPTIONAL: I would like to meet with my counselor concerning something on this form: List your name and homeroom teacher!
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