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Minute Meeting
WELCOME BACK TO SCHOOL!!!! This short survey is to help your school counselor get to know you a bit more.
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Wade Carpenter Middle School
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MM
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DD
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YYYY
First and Last Name
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Your answer
Grade
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6th
7th
8th
Getting To Know You
Please answer the following questions to the best of your knowledge
How is your year going so far?
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Could be better
OKay
Terrible
Good
I need help
Amazing!!!
Do you like school?
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Sometimes
No
Yes
How are you doing in your classes?
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Great!
Getting work turned in
Struggling
Not so good
Do you have friends?
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Many
A few
One
None
Do you have support or someone to talk to about your problems?
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Friends
Parents/Guardian
Counselor or School Counselor
Teacher
Other:
What is your goal for this school year?
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Your answer
What is your goal for the future?
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Your answer
What would you like to learn from your school counselor this school year?
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Your answer
Would you like to talk to your school counselor in private about something?
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Suicide
Self-harm
Depression
Anxiety
Bullying
Trauma
Friendships
Divorce
Grief or Loss
Other:
Would you be interested in joining any counseling groups?
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Yes
No
Maybe
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