Alameda Unified Health and Wellness Assessment Family Survey
Introduction: Alameda Unified School District is conducting a needs assessment to help plan behavioral health service delivery for Alameda Unified. As part of that planning, we are interested in hearing what families think about behavioral health issues and supports in your school community. The information you provide will not be used to identify you. Demographic questions will be used to understand our overall respondent pool and will not be linked to your individual responses on this survey. Please answer the questions honestly—there are no right or wrong answers. Your answers are confidential. The survey will take about 15 minutes to complete.
What school does your child attend?
What is your child's grade level?
What is your child's gender?
How many students at your child's school site do you think are affected by the following?
A lot
Some
Little
None
Teasing
Bullying
Depression/feeling sad
Drug or alcohol use
Problems at home (with family, fighting, divorce)
Feeling disconnected at school (to other students and/or staff)
Feeling lonely or left out
Feeling unsafe (due to violence, fights, threats)
Feeling worried, anxious or stressed
Relationship issues (friendships and/or dating)
Sexual harassment (unwanted touching or advances)
Other, please specify A:
Your answer
If the school were to offer more programs or supports to help students, which of the following would be most helpful?
Very helpful
Helpful
Somewhat helpful
Not helpful
Clasroom presentations on topics like bullying, how to recognize emotional problems, and where to get help
Crisis services - a place to go when a student needs help right away
Ongoing counseling with a therapist or other trained adult
Group counseling or a support group with other students led by a therapist or other trained adult
Student assemblies on issues like bullying
Training for teachers and other school staff to support students on issues like bullying
Other, please specify B:
Your answer
How much do you agree with the following statements about your child's school?
Strongly disagree
Disagree
Neither agree or disagree
Agree
Strongly agree
Teachers show respect for and care about me.
Teachers show respect for and care about all their students.
Support for students that are having a hard time is offered fairly and equally for all students.
Consequences for not following school wide expectations are enforced equally for ALL students
Students understand school wide behavioral expectations and what the positive and negative consequences are
I have an adult on campus I can go to and trust if I need extra support
When your child has needed counseling to deal with stress or a personal problem, where have you received the help you needed? Check all that apply
Other (specify):
Your answer
Does your child's school engage in any of the following strategies to help build a positive school community? Check all that apply.
Other (please describe)
Your answer
What suggestions do you have to improve the health and well-being of students at your child's school?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Alameda Unified School District. Report Abuse - Terms of Service