Counseling Survey
We are Stronger Together!
This survey is entirely confidential. The counseling department wants to find out what concerns Table Rock students have. PLEASE BE HONEST! Nobody except the counselors will know it was you who filled out the survey!
1. If you would like to talk about any of the below issues, write YOUR FIRST AND LAST NAME in the box.
Your answer
Grief/ Loss of a loved one
Your answer
Your answer
Friendship skills
Your answer
Family member in prison
Your answer
Family member's drug and alcohol abuse
Your answer
My drug and alcohol abuse
Your answer
Dealing with family life
Your answer
Other (tell us your concern and your name)
Your answer
2. Do you feel safe at Table Rock? *
3. Are you nice to classmates who seem "different" or are new to the school? *
4. Have you ever stuck up for a classmate who was being bullied? *
5. Has a friend ever pressured you into doing something you did not want to do? *
6. Is there an adult at Table Rock you can trust? *
7. Have you ever bullied someone at Table Rock? *
Please choose up to three of your biggest concerns: *
Click to check, click to un-check. Count to make sure you only choose THREE.
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