2019-2020 Leinkauf Elementary 3-5 Student Needs Assessment
Your school counselor is someone who can help you with some of the challenges you may be having. Please answer "YES" or "NO" to the questions below. Your school counselor would love to know more about you and how to help you at school!
What is your Current Grade Level
I know who my school counselor is
I would go see or ask my school counselor for help if I needed to
I Feel Safe at School
I do not feel Safe at all
I feel very Safe
I need help with: (check the boxes next to things you could use help with)
understanding and liking myself
dealing with peer pressure
making and keeping friends
dealing with a bullying situation
dealing with the separation or divorce of my parents
dealing with a family member being in jail or prison
dealing with the death of a family member or close friend
understanding drug and substance abuse
dealing with being taken out of my home
expressing anger in a good way
improving my study skills
getting food, clean clothes, a home or a place to sleep
dealing with stress or being scared or worried
I feel safe at home
I know of at least 1 person at my school who I can talk to if I have a problem
I know of at least 1 person outside of my school who I can talk to if I have a problem
Speaking to the counselor is :
Use this section to tell your school counselor about topics or situations you need to talk about.
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This form was created inside of Mobile County Public School System.