ASE NEEDS ASSESSMENT SURVEY
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Rate each item 1 (Not at all) to 5 (Very much)

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STUDENT VERSION

Academic and Learning Environment
1. I feel like the adults at this school believe I can succeed.         1 2 3 4 5
2. My teachers know what kinds of learning work best for me.            1 2 3 4 5
3. I know how to get help when I am struggling with schoolwork.         1 2 3 4 5
4. I have a plan for what I want to do after high school.               1 2 3 4 5

Social-Emotional and Wellbeing
5. I feel like I belong at this school.                                 1 2 3 4 5
6. There is an adult at this school I can talk to when something        1 2 3 4 5
   is hard.
7. I know how to manage my feelings when I am stressed or upset.        1 2 3 4 5
8. When something unfair happens at school, I feel like someone         1 2 3 4 5
   will listen to me.

School Environment (ASE environmental questions)
9. My life outside school affects how I do at school.                   1 2 3 4 5
10. The adults at this school understand what my life outside           1 2 3 4 5
    school is like.
11. This school is a place where students like me are respected.        1 2 3 4 5
12. When students have a conflict, the adults here handle it            1 2 3 4 5
    in a way that feels fair.

Open-ended:
What is the best thing about this school?


What is the hardest thing about this school?


If you could change one thing to help students like you, what would it be?


Is there anything the school counselor could help with that they aren't currently?


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TEACHER VERSION

1. I feel supported by the school counselor in addressing students'     1 2 3 4 5
   social-emotional needs.
2. I know how to reach out to the school counselor when a student       1 2 3 4 5
   needs support.
3. The school counseling program is visible and accessible to all       1 2 3 4 5
   students, not just those with acute needs.
4. I understand the connection between classroom environment and        1 2 3 4 5
   student social-emotional development.
5. I have received PD on supporting students' regulation and wellbeing. 1 2 3 4 5
6. Students in my classroom feel safe enough to take academic risks.    1 2 3 4 5
7. I am aware of community and family stressors affecting my students.  1 2 3 4 5

Open-ended:
What student needs are you observing that the counseling program is not currently meeting?


What would be most helpful in terms of counselor support or collaboration?


What environmental changes would most benefit your students?


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FAMILY VERSION

1. I feel welcome at my child's school.                                 1 2 3 4 5
2. I know how to contact the school counselor.                          1 2 3 4 5
3. The school counselor is someone I trust with my child's wellbeing.   1 2 3 4 5
4. I feel like the school understands my family's values.               1 2 3 4 5
5. My child feels safe at school.                                       1 2 3 4 5
6. I know what resources are available if my family needs support.      1 2 3 4 5

Open-ended:
What is most important to you about your child's experience at school?


What would help your family be more connected to school?


Is there anything the counselor could do differently to better support your child?


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