Wellbeing Check

Script

This document is intended to be used to help facilitate conversations with children and their parent /
guardian or adult in the household. Remember, the information you are asking is personal, private, and
can be sensitive to some of the individuals you speak to. It is critical to:
- establish a positive relationship,
- always use kind and supportive language,
- never judge or use value-based language,
- be understanding and responsive to the content shared,
- avoid applying any pressure to respond, and
- Follow-through with following-up if the child and or household requests or gives permission.

Step 1: Preparation
Be sure you have:
checked your mindset to ensure you are mentally ready to be available and supportive
checked to ensure your appearance is professional and approachable (if in person or
through a virtual call)
any tracker or tools for documentation ready
reviewed the script
literature or resources available to share
your calendar available to schedule any requested follow-up

Step 2: Conduct the Wellbeing Check

Introduce yourself and the wellbeing check:

SAY: “Is there a parent or adult in the household I may speak to?”
*If an adult is not home, ask when they might be home and call back. Do not proceed with
speaking to the child unless prior permission had already been granted

SAY: “Hello, my name is ____________ and I am talking with you today to make sure your
house hold and the children in your home are doing okay due to the current crisis”

SAY: “Do you have a couple of minutes to talk with me?”

If yes: If no:
*Continue with the rest of the script SAY: “Is there a better time or would you like
to schedule a time for me to call back?”

If no: document that the house hold was not

receptive to a wellbeing check

1
 If yes: schedule the time and ensure you are
able to follow-up when you said you will.
SAY: “Before we get started, I want to ensure you understand the nature and the scope of
our conversation:
1. Participating in this wellbeing check is optional.
2. Information gathered will be used to ensure children and families are supported during
times of crisis such as the COVID-19 pandemic.
3. All individual responses will be held confidential unless you specifically request, and
authorize in writing, a resource or service, then personal information may be used to ensure
access to supports. Your permission will always be requested in advance. No personally
identifiable information will be shared or used for reporting purposes.
4. Due to mandatory reporter requirements, if there is a safety concern for a child in the
household, then there is an obligation to report as a matter of public safety.
5. It is our goal to communicate with each child directly, do we have your permission to speak
with the children in the household?
If yes: If no:
SAY: “Great! I would like to ask you a SAY: “No problem! I would like to ask you a
couple of questions prior to speaking to couple of questions.”
your child / children.”
*Continue with the rest of the script
*Continue with the rest of the script OMMITTING the portion communicating
with the child / children

SAY: “Please know that you are not required to answer all of these questions. As a reminder,
information collected is for the purpose of identifying any resources or services that may be helpful
to you, your house hold or your child / children during this crisis. We might not be able to provide you
with support you would like, but we will at least follow-up with you after this call, should you prefer.”

Begin the Wellbeing Check:

SAY: “Overall, how are you doing?”

*Listen intently. Be understanding. Do not interrupt or make value-based statements in
response.

PROCEED WITH THE QUESTIONS DEVELOPED BY THE LOCAL WELLBEING COMMITTEE

*After asking the questions:

If you have permission to speak with the
child / children:
SAY: “Thank you for your time today. I have
a couple of resources I would like to share
with you should you find them beneficial or
would like to use in the future. (*share
local resource guides*) Would you like to
schedule a follow-up conversation?”
If you DO NOT have permission to speak
with the child / children:
SAY: “Thank you for your time today. I have
a couple of resources I would like to share
with you should you find them beneficial or
would like to use in the future. (*share
local resource guides*)Would you like to
schedule a follow-up conversation?”

If yes: schedule an appointment and ensure If yes: schedule an appointment and ensure
you follow-through on following-up you follow-through on following-up
 If yes or no AND the family member
requested follow-up from a local health
care provider: “Would you like me to share
your information with a local health care
provider?
If yes or no AND the family member
requested follow-up from a local health
care provider: “Would you like me to share
your information with a local health care
provider?

If yes: “Great! I am going to send you a
‘release of information waiver’ giving me
permission to share your contact
information. Do you have an email address
I can send the form to? Please return the
signed form as soon as you are able. I will
not be able to share your contact
information until the form is returned.”
If yes: “Great! I am going to send you a
‘release of information waiver’ giving me
permission to share your contact
information. Do you have an email address
I can send the form to? Please return the
signed form as soon as you are able. I will
not be able to share your contact
information until the form is returned.”

Regardless of follow-up options selected: If no: “Great! Again, thank you for your
“Great! May I please speak to NAME OF time. I wish you and your house hold all the
CHILD / CHILDREN in the home?” best”

*Continue with the rest of the script *END CONVERSATION

Conversation with Child:

SAY: “Hi, my name is ____________ and I am talking with you today to make sure you are
doing okay. I just spoke with MOM / DAD / RELATIVE / NAME and now I would like to talk
with you. Is that okay?”

If yes: If no:
*Continue with the rest of the script SAY: “That’s okay! I know it can be scary to
talk to someone you don’t know. Do you
have someone in your house you would
like to be with you?”

If yes: *continue with the rest of the script

If no: SAY “that’s okay! Maybe another

time. Have a good day. Bye-bye”.

SAY: “How are you doing?”

*Listen intently. Be understanding. Do not interrupt or make value-based statements in
response.

PROCEED WITH THE QUESTIONS DEVELOPED BY THE LOCAL WELLBEING COMMITTEE

*After asking the questions:

 SAY: “Thank you so much for your time today. I appreciate you talking to me. We might be
talking again in the future should you think of anything else you want to tell me later. Have a
good day. Bye-bye.”

Step 3: Close-out

Make sure all necessary information is documented. If there are needs flagged, ensure those are
surfaced through the pre-determined avenues.

Confirm that any follow-up appointments are scheduled.