Counselor Check In
Hi! It's Mrs. Jefferis, your School Counselor at Cypress Creek Elementary School. I am checking in to see how you are doing and to see if there is anything that I can help with. Answer as many or as few as you'd like - the more, the better! Your answers are private to Mrs. Jefferis only.
Today's date *
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DD
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First Name *
Your answer
Last Name *
Your answer
Grade *
How are you feeling today?
How was your breakfast or lunch?
Your answer
How is everything at home?
Your answer
What are some strategies you have used or could try when you have uncomfortable feelings (like being sad, angry, nervous or scared)?
Your answer
What are some activities that you like to do while you are at home? Things I enjoy are...
Your answer
Do you need a check in phone call from Mrs. Jefferis?
Anything else you would like to share?
Your answer
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