Student and Family Needs Assessment
This survey will assist Avoca West and Marie Murphy in providing social and emotional supports and resources for students and families as we continue to navigate these challenging times. Please complete one survey per family.
Email address *
Student(s) Name ~ Nombre del estudiante(s) *
Has the COVID-19 pandemic had an impact on the family? ~ ¿La pandemia COVID-19 ha tenido un impacto en su familia? *
Required
Have you observed A CHANGE in any of the following behaviors in your child? ¿Ha observado un cambio en alguno de los siguientes comportamientos en su hijo? *
Required
My child/children are mostly feeling *
Required
Has your student(s) voiced any safety or emotional well-being concerns regarding the return to school? If yes, please explain. ~ ¿Ha expresado su estudiante alguna preocupación por la seguridad or el bienestar emocional en relación con el regreso a la escuela? Si es así, por favor explique.
Does your family have any specific needs that the district might be able to assist? (school fees, food, technology, internet access, links to social service agencies, etc.) ~ ¿Tiene su familia alguna necesidad especifica que el distrito pueda atender?
Would you like a district staff member to reach out to you to discuss further? ¿Te gustaría que un miembro del districto se ponga en contacto contigo para discutir en más profundidad? *
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Avoca School District 37.