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Pinnacle High School Needs Assessment Survey
Mark each with the following:
Option 1: I am aware this and it is not a current concern
Option 2: I think about this sometimes
Option 3: I need to talk to someone about this right away
First Initial (Example: A.) *
Your answer
Last Name *
Your answer
Grade *
Your answer
1. Dealing with change/new situations *
Required
2. Difficulty controlling anger *
Required
3. Receiving one or more failing grades *
Required
4. Fights (Family and friends) *
Required
5. Having a problem with alcohol or drugs *
Required
6. A divorce, separation or death in the family *
Required
7. Loss of a loved one *
Required
8. Loss of a close friend or relationship *
Required
9. A problem getting along with friends or others *
Required
10. Bullying/harassment *
Required
11. Teenage pregnancy *
Required
12. Stress *
Required
13. Hurting/cutting oneself *
Required
14. Thinking/talking about suicide *
Required
15. Feeling sad or depressed most of the time *
Required
16. Rumors and gossip *
Required
17. Dropping out of school *
Required
18. Eating disorders *
Required
19. Not accepting peoples' differences *
Required
20. Afraid to come to school *
Required
21. Fear of making mistakes *
Required
22. Skipping school *
Required
23. Test anxiety *
Required
24. Not getting along with teachers *
Required
25. Family addictions *
Required
26. Not having a trusted adult at school to talk to *
Required
27. Feeling unsafe at school *
Required
28. LGBTQ (Lesbian, gay, bi-sexual, transgender, questioning) Issues *
Required
29. Group Interest
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