Student Needs Assessment
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First Name *
Last Name *
Grade *
Do you know your School Counselor's name? *
Do you know what your School Counselor does at your school? *
Do you know how to let your School Counselor know if you need to talk about a problem? *
Do you know where your School Counselor's office is located? *
Do you have friends at school? *
If you have a problem, who are some of the grown-ups at school you feel comfortable talking to? (Check all that apply) *
Required
If you have a problem, who are some of the grown-ups outside of school you feel comfortable talking to? (Check all that apply) *
Required
I need help with (Check all that apply)
Do you have any worries or concerns that you would like to talk to your School Counselor about in private?
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