Family - Student Check-in - Is there a need for counseling or emotional support?
We care about you. We are here for you. Help us know the best way to support your child and you during this time. Please take a moment to complete this quick survey. If this is a mental health emergency, please dial 911.
Name of person completing this survey:
Your answer
Name (s) of student:
Your answer
School attending:
How are you and your family doing? *check what applies to you.
What is the best number to reach you?
Your answer
We are struggling with... *check all that apply:
I wish the school would:
Your answer
Is there someone at school that your child would like to communicate with?
Your answer
Anything else we should know?
Your answer
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