SMS Needs Assessment 2019-20
Counselors address the needs of all students and we ask all students to complete this form so we can best serve the Sherwood Middle School student body. This information is held CONFIDENTIAL by the School Counseling Department.
Your First Name *
Your Last Name *
Student ID
What grade are you in? *
Tell us about your academic life *
This section refers to Academics
False, this does not apply to me
True, but it doesn't bother me
True. It bothers me sometimes
True. I think about this a lot.
I have a hard time staying organized.
I am too busy. I can't get everything done.
I have a hard time with math
I have a hard time reading
I have a hard time writing
Tells us about your AVID Binder experience *
Strongly Agree
Agree
Disagree
Strongly Disagree
I like using a three-ring binder for my class work
I have access to the supplies I need
I use my planner everyday
The AVID binder is helpful in keeping me organized
I feel more prepared for classes when I am organized
I have the support I need to be successful at school
Getting an education beyond high school is important to me
Tell us about yourself *
This section refers to your Self
False, this does not apply to me
True, but it doesn't bother me
True. It bothers me sometimes
True. I think about this a lot.
I have trouble making friends
I have trouble keeping friends
People bully me
I have lost a family member or close friend (Death)
I worry about what I look like/my body
I have used drugs or alcohol
When I get angry I lose control
I have thought about hurting myself
Tell us about your family *
This section refers to your Family
False, this does not apply to me
True, but it doesn't bother me
True. It bothers me sometimes
True. I think about this a lot.
My parents are divorced or planning a divorce
My family fights a lot
At home, my family is violent (hitting, throwing, shaking)
I have a family member who is in jail/prison
I have a family member who drinks too much
I have a family member who is often sick or ill
I have a family member that does a lot of drugs
Where I live, I have access to
All the time
Sometimes
Never
The internet
Clear selection
If you have additional information to share, please do so here.
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