Student Survey to Inform Advisement
The purpose of this student survey is to inform the RT student advisement process. Although there is no magic formula to assure student success, it is the intention of this process to identify student support services and resources that may effectively promote student success when put into effect.

Answers to the following questions may provide insight for faculty to realistically advise all students.

This survey is due by the end of day this Friday. Your answers are confidential between you and program faculty/staff.

Program faculty/staff will respond by completing the Week 6: RT Student Advisement Form and sharing it confidentially and individually with each student by Week 6 of this semester.

Last Name *
Your answer
First Name *
Your answer
Semester *
Your answer
Clinic/Hospital Assignment *
Your answer
Student ID Number *
Your answer
1. I generally feel that I am academically prepared for this level of college work and have commitment to personal progress. *
Required
Additional Comment(s):
Your answer
2. I am concerned about my challenges at the basic needs level because I have food insecurities. *
Required
Additional Comment(s):
Your answer
3. I am concerned about my challenges at the basic needs level because I have housing insecurities. *
Required
Additional Comment(s):
Your answer
4. I have family responsibilities that affect my wellness. *
Required
Additional Comment(s):
Your answer
5. Work commitments limit the number of hours I can spend on schoolwork. *
Required
Additional Comment(s):
Your answer
6. I am aware of financial aid services available to me. *
Required
Additional Comment(s):
Your answer
7. I am aware of psychological counseling services available to me through Student Health Services. *
Required
Additional Comment(s):
Your answer
8. I am aware of peer mentoring available to me. *
Required
Additional Comment(s):
Your answer
9. I am aware of tutoring available to me.*
Additional Comment(s):
Your answer
10. I am aware of services provided at the Accessibility Support Center.*
Additional Comment(s):
Your answer
11. I am aware that if I am experiencing a health issue, there are student resources at Student Health Services.*
Additional Comment(s)
Your answer
12. I am aware that if I am experiencing a mental health issue, there are student resources at Student Health Services.*
Additional Comments
Your answer
13. I am aware that if I am experiencing an addiction issue, there are student resources at Student Health Services.*
Additional Comment(s)
Your answer
14. I have a sense of belonging in the RT program.*
Additional Comment(s)
Your answer
15. Sometimes I think about having a fear of failure.*
Additional Comment(s)
Your answer
16. Sometimes I think about having a fear of success.*
Additional Comment(s)
Your answer
17. Being in this program contributes to my strong sense of purpose.*
Additional Comment(s)
Your answer
18. I consider my classmates as colleagues.*
Additional Comment(s)
Your answer
19. I consider my classmates as peer mentors.*
Additional Comment(s)
Your answer
20. I consider my classmates as friends.*
Additional Comment(s)
Your answer
21. I have explored the possibility of joining a carpool to commute to my clinical education site.*
Additional Comment(s)
Your answer
22. I am aware of off-campus temporary housing found at the student services web-site: Student Resources Off-Campus.*
Additional Comment(s)
Your answer
23. I am aware of emergency food resources found at the student services web-site: Student Resources Off-Campus.*
Additional Comment(s)
Your answer
24. To be successful, Students get help when they need it.*
Additional Comment(s)
Your answer
25. My communication with patients is professional and demonstrates appropriate emotional intelligence.*
Additional Comment(s)
Your answer
26. My communication with instructors is professional and demonstrates appropriate emotional intelligence.*
Additional Comment(s)
Your answer
27. My communication with technologists is professional and demonstrates appropriate emotional intelligence.*
Additional Comment(s)
Your answer
28. My communication with physicians is professional and demonstrates appropriate emotional intelligence.*
Additional Comment(s)
Your answer
29. My communication with classmates is professional and demonstrates appropriate emotional intelligence.*
Additional Comment(s)
Your answer
30. When graded quizzes/tests are returned to me, many of the questions missed contain content that I knew, but my anxiety during the test blocked the information from my consciousness.*
Additional Comment(s)
Your answer
31. I am a Veteran and am aware of the services available to me through the Veterans Center on campus.*
Additional Comment(s)
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Cabrillo College.