Student Needs Assessment (High School)

Age:
Gender:
Ethnicity:
Grade level:
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:
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

Strongly
Agree

Agree

Neither
Agree nor
Disagree

Disagree

Strongly
Disagree

10. Concerns about

alcohol and/or drug use
11. Helping myself
(gaining more selfconfidence, 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:
25. Being more organized
26. Managing my time

Strongly
Agree

Agree

Neither
Agree nor
Disagree

Disagree

Strongly
Disagree

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

Strongly

Agree

Neither

Disagree

Strongly

you agree with the

following statements:
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.
54. Someone in the school
has regularly helped me
plan for my future career.
55. There is at least one
staff member in the
school that I believe cares
deeply about me and my
success.

Agree

Agree nor
Disagree

Disagree

Please check how much

you agree with the
following statements:
56. I have a clear career
plan to follow when I
graduate.
58. I am involved in at
least one school activity
outside of class.
59. I understand why I
need a good education.
60. I will stay in school
until I graduate high
school.
61. I will continue my
education after high
school.

Strongly
Agree

Agree

Neither
Agree nor
Disagree

Disagree

Strongly
Disagree