Panther Middle School Needs Assessment - Google Forms

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4/26/2021 Panther Middle School Needs Assessment

Panther Middle School Needs


Assessment
The counseling department would like you to please answer the following questions to the
best of your ability. Please know that your answers will remain confidential. This assessment
is intended to assess how we can better support students of Panther Middle School.

* Required

1. What grade are you currently in? *

Mark only one oval.

Grade 6

Grade 7

Grade 8

2. Gender (optional)

Mark only one oval.

Female

Male

Non-Binary

Prefer not to say

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4/26/2021 Panther Middle School Needs Assessment

3. Race/Ethnicity (optional) - select all that apply

Check all that apply.

White
Black/African American
Hispanic/Latinx
Asian American/Pacific Islander
Native American
Two or more races
Other:

4. I struggle to find transportation to school (optional)

Mark only one oval.

Never

Rarely/Seldom

Sometimes

Often

All the time

5. I have difficulty concentrating in class *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

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4/26/2021 Panther Middle School Needs Assessment

6. I need help preparing for tests and/or studying *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

7. I have a hard time completing my homework *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

8. I have a hard time turning in homework *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

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4/26/2021 Panther Middle School Needs Assessment

9. I would like to join a peer study group. *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

10. I know how to ask for help when I have questions about my assignments. *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

11. I know who my counselor is *

Mark only one oval.

Yes

No

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4/26/2021 Panther Middle School Needs Assessment

12. I feel comfortable going to my counselor to get help with SCHOOL concerns *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

13. I know my options for college after high school *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

14. I know about career options after high school *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

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4/26/2021 Panther Middle School Needs Assessment

15. I need help making friends at school *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

16. I feel comfortable going to my counselor about PERSONAL concerns *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

17. I need help getting involved in more school activities *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

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4/26/2021 Panther Middle School Needs Assessment

18. I need help managing my anger *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

19. I need help managing my stress *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

20. I need help managing my school work *

Mark only one oval.

Strongly Disagree

Disagree

Neither Agree nor Disagree (Neutral)

Agree

Strongly Agree

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4/26/2021 Panther Middle School Needs Assessment

 Forms

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