Student Counseling Check-In 
Please use this form to provide a quick check-in for your counseling needs.
Email *
Name
E-mail Address
Grade
How are you doing today?
Not so good
Awesome
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How are things at home?
Not so good
Awesome
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How do you feel about school?
Not so good
Awesome
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How safe do you feel at this school?
Not so good
Awesome
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Do you feel you have an adult at this school you can trust?
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Do you feel you have a friend at this school you can trust?
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Do you have any goals for this year?
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What are your goals?
What are you most excited about or looking forward to the most this year?
What fun fact do you want me to know about you?
Is there anything that you want to talk to be about at another time?
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