District 19's Wellness Check-in
We want to know how you are doing and the best way to support you and your child(ren) during this time. Please take some time to fill out this quick survey. Thank you in advance
Name of Person Completing the Survey
Relationship to the student
How are you and your family doing? Check all that apply
We are doing well.
We are doing okay. Thankful we are not sick.
We have sick family members, but we are doing okay.
We are not doing well at all physically, and would love some help.
We are not doing well at all emotionally, and would love some help.
Please call us. We would like to talk.
We are struggling with....Check all that apply.
Completing work from school
Communicating with teachers and school staff
Household necessities (i.e., food, paper products, personal hygiene items, etc.)
We are going stir crazy! We need ideas on how to keep the kids occupied!
I wish the school would...
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This form was created inside of NYC Department of Education.