Client Survey
Directions: Read each statement. Respond to the statements by selecting the response (YES, SOMETIMES, or NO) that best describes how you feel about the statement.
Teacher Name *
Your answer
School Year *
Your answer
Homeroom Teacher *
Your answer
My teacher listens to me. *
My teacher gives me help when I need it. *
My teacher shows us how to do new things. *
My teacher encourages me to evaluate my own learning. *
I am able to do the work in class. *
I learn new things in my class. *
I feel safe in this class. *
My teacher uses many ways to teach. *
My teacher explains how my learning can be used outside of school. *
My teacher explains why I get things wrong on my work. *
My teacher shows respect to all students. *
My teacher demonstrates helpful strategies or skills for my learning. *
There are opportunities to reflect on my learning in my class. *
My teacher allows me to make some choices about my learning. *
Comments?
Your answer
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