Needs Assessment 3-5
2017-2018
I need help with the following concerns: *
Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
Making friends
Fitting in at school
Dealing with peer pressure
Improving communication
Getting Involved in school activities
Concerns about alcohol or drug use
Helping myself
Being teased or bullied
Getting along with family
Getting along with friends
Feeling sad or depressed
Feeling sad about someone passing away
Parental divorce or separation
Dealing with anger
Feeling stressed
Skills for resolving conflict
Being more organized
Learning how to study better
Reducing test anxiety
Improving test taking skills
I can see my counselor when I need to
I know my counselor can help me with SCHOOL issues.
I know my counselor can help me with ANY concerns.
I like coming to school.
I know how I can request to see my counselor.
Name *
Your answer
Grade
Submit
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