Needs Assessment

Intro School counseling students from DePaul University created this survey to better
understand the needs of the students at Lake View High School, and the results of the
survey will help your school to better serve you.
Pt1 Please choose an option that best describes you:
1 Gender
Male (1)
Female (2)
Prefer not to answer (3)
Other (please specify) (4) ____________________
2 Ethnicity
Asian or Pacific Islander (1)
African-American/Black (2)
Hispanic/Latino (3)
Caucasian (Not of Hispanic Origin) (4)
More than one of the above (5)
Other (please specify) (6) ____________________
3 Sexuality
Straight (1)
Gay/Lesbian (2)
Bisexual (3)
Questioning (4)
Prefer not to answer (5)
Other (please specify) (6) ____________________
4 What services do you use to get to school? (Select all that apply)
Walk (1)
Train (2)
Bus (3)
Car/ride from family/friend (4)
5 What neighborhood do you live in?
Pt2 Please select how much you agree or disagree with the following statements:

6 I feel safe at school.

Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)
If Strongly Agree Is Selected, Then Skip To Bullying is a problem at our school.If
Somewhat Agree Is Selected, Then Skip To Bullying is a problem at our school.
6 Please explain why you do not feel safe at school.

Pt2 Please select how much you agree or disagree with the following statements:
7 Bullying is a problem at our school.
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)
8 I have a positive relationship with the majority of my teachers.
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)
9 I have someone at home that I am close and can talk about anything with.
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)

Pt2 Please select how much you agree or disagree with the following statements:
10 The topics that we talk about in advisory are helpful to me.
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)
11 Please explain your answer further from the previous question (If helpful, why? If not,
why not?)
12 I am aware of resources located inside Lake View High School that can help me with
my classes.
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)

Pt2 Please select how much you agree or disagree with the following statements:
13 I feel comfortable asking for help whenever I need it.
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)
14 Being involved in extracurriculars at school is important to me (ex. sports, clubs,
groups, etc.)
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)
15 I feel like what I am learning at Lake View will help for any post-secondary
educational plans.
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)

Pt2 Please select how much you agree or disagree with the following statements:
16 My parents/guardians encourage me to go to college.
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)
17 I am aware of all my options after graduation.
Strongly Agree (1)
Somewhat Agree (2)
Somewhat Disagree (3)
Strongly Disagree (4)

Pt3 Please select how often the statement applies to you:

18 I get harassed, abused, and/or bullied (physically, verbally, and/or emotionally) while
in school.
Always (1)
Usually (2)
Sometimes (3)
Never (4)
19 I would rather be somewhere else than at school
Always (1)
Usually (2)
Sometimes (3)
Never (4)
20 I feel supported by my teachers, counselor, and other staff in the building.
Always (1)
Usually (2)
Sometimes (3)
Never (4)

Pt3 Please select how often the statement applies to you:

21 I utilize school resources to help me with my classes.
Always (1)
Usually (2)
Sometimes (3)
Never (4)
22 My parents/guardians talk to me about going to college.
Always (1)
Usually (2)
Sometimes (3)
Never (4)
23 I think about my future after high school.
Always (1)
Usually (2)
Sometimes (3)
Never (4)
Pt4 Please select and/or write in a response that most accurately reflects what is true for
you:
24 Please choose the response that best describes your current plans for after
graduation.
I plan to apply for college, and I know where. (1)
I plan to apply for college, but I dont know where. (2)
I want to go to college, but I am not sure if I will apply. (3)
I dont want to go to college, and plan to enter the work force. (4)
I dont know enough about college/unsure. (5)
25 Which issues do you feel comfortable with talking to your counselor about? Select all
that apply:
Personal/relationship issues (friends, family, significant other, etc.) (1)
Issues with teachers or other staff (2)
Issues with classes (tests, assignments, instruction, etc.) (3)
Plans after high school (4)
26 "I am currently passing __ of my classes with a C or better"
1 (1)
2-3 (2)
4-5 (3)
All (4)

27 How many days of school do you miss per month?

0-1 (1)
2-3 (2)
3-5 (3)
6+ (4)
28 What is the most common reason you may be absent from school?
29 Is there anything else about your experience at Lake View High School that you
would like to share?