Mental Health Screener

Please take a few minutes to fill out this quick questionnaire about your child(ren) by September 5, 2020. This information will be used to plan for the upcoming year and to ensure that your child(ren) have an easy and healthy adjustment back to the classroom. All answers provided will remain confidential.

Family Name
What is your child(ren)’s understanding of COVID-19?
Has your child(ren)/ family lost anyone as a result of COVID-19 (If so, what is the relationship)?
Have there been any significant changes in your family that the school should be aware of?
My child(ren) wear a mask (check all that apply):
- Always when out of the house
- Only in stores
- At the playground
- Never/Rarely
How does your child(ren) feel about wearing a mask?
Have you noticed any changes in your child(ren)’s mood or behaviors since COVID-19?-please explain
How did your child(ren) adjust to the remote learning?
What worked/ did not for you child(ren) with the remote learning?
What did your child(ren) do this summer?
How does your child(ren) feel about returning to school?