Ben Lomond Family Weekly Check-In

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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 for your help.

Ben Lomond Staff

Name of Person Completing Survey * *

Name(s) of Student(s) Who attend Ben Lomond *

How are you and your family doing? Check all that apply. * *

We are doing well.

We are doing ok. Thankful we are not sick.

We have sick family members, but we are doing ok.

We are not doing well at all, either physically or emotionally, and would love some help.

Please call us. We would like to talk.

Required

We are struggling with... Check all that apply. *

Technology (accessing apps/programs)

Technology (computer hardware issues/cords/connectivity to internet)

Technology (other)

Household necessities (i.e., food, paper products, personal hygiene items, etc..)

Childcare resources/options

Staying organized

We are going stir crazy! We need ideas on how to keep the kids occupied.

Other:

I wish the school would...

Any other information you'd like us to know?

If you'd like to be contacted, the best way for a staff member to reach you is:

Phone

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My phone number is

My email is

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