Student Needs Assessment (High School)

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School:
Age:
Gender:
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Grade level:
Code: (leave blank if none provided)  
Student Instructions: The school counseling department wants to ensure we develop and provide programs that meet your needs and determine / know how well you believe the school counselor is meeting your needs. Please be totally honest in your responses. Only you will know the answers you provide as we include no student identifying information on this survey. This survey will help us learn how many students need programs and activities on certain topics. Thank you for helping us better meet your needs. PLEASE READ EACH STATEMENT AND MARK THE MOST APPROPRIATE ANSWER CHOICE FOR YOU.
Answer each statement and check how true it is.
I need help with the following PERSONAL concerns:		Strongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly Disagree
1. Making friends
2. Fitting in at school
3. Dealing with peer pressure
4. Making better decisions
5. Improving communication
6. Transitioning to a new school
7. Pregnancy Teen/Parenting
8. Getting involved in school activities
9. Dating or relationship issues
10. Concerns about alcohol and/or drug use
11. Helping myself (gaining more self-confidence, feeling better about myself, expressing my feelings and thoughts)
12. Being more assertive
13. Handling teasing or being bullied
14. Getting along with other students better
15. Getting along better with family members
16. Feeling sad or depressed
17. Feeling suicidal
18. Grief over the loss of a loved one
19. Parental divorce of separation
20. Dealing with anger
21. Feeling stressed
22. Feeling anxious or irritable
23. Concerns about alcohol and/or drug use
24. Skills for resolving conflicts
I need help with the following SCHOOL concerns:Strongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly Disagree
25. Being more organized
26. Managing my time better
27. Improving study skills
28. Reducing test anxiety
29. Improving test-taking skills
30. Understanding what my test scores mean in relation to academic and career planning
31. Developing my course schedule
32. Understanding the best career options for me
33. Planning my options after high school
34. The college application process
35. Understanding my learning style to improve how I learn
36. Knowing about and applying for scholarships and financial aid
37. Knowing what educational options are available to me when I graduate
38. Getting along with teachers
39. Transitioning to a new school
40. Understanding graduation requirements
41. Selecting a career cluster or concentration
Please check how much you agree with the following statements:Strongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly Disagree
42. I know who my counselor is.
43. My counselor likes me.
44. My counselor is available to me when I need to see/him or her.
45. I feel comfortable going to see my counselor to get help with SCHOOL concerns.
46. I feel comfortable going to see my counselor to get help with PERSONAL Concerns.
47. My classes keep me interested in the topic.
48. I like coming to school.
49. My teachers are willing to help me when I have questions.
50. My counselor has met individually with me least once to help me plan my schedule for next year.
51. The school is involved in my developing my education plan.
52. My counselor has met individually with me least once to help me understand the relevance of the state assessment and what my scores mean to me.
53. Someone in the school has regularly helped me plan for my future career.
54. There is at least one staff member in the school that I believe cares deeply about me and my success.
Please check how much you agree with the following statements:Strongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly Disagree
55. I have a clear career plan to follow when I graduate.
56. I understand why I take the state assessment.
57. I am involved in at least one school activity outside of class.
58. I understand why I need a good education.
59. I will stay in school until I graduate high school.
60. I will continue my education after high school.
OTHER CONCERNS: Please list any other concerns or needs that were not mentioned that YOU PERSONALLY would like the school to help you with: