1/13/2020 Freshman Seminar Needs Assessment

Freshman Seminar Needs Assessment

The counseling department a Costa Mesa High School strives to support the academic, college and
career, and mental health needs of all students. The purpose of this survey is to understand what
students want to know more about related to their mental health and well being. Please complete the
following survey with answers that best apply to you.

* Required

1. I know what mental health is. *

Mark only one oval.

True
False

2. I believe my mental health is just as important as my physical health. *

Mark only one oval.

True
False

3. What are some things that stress you out (Check all that apply)? *
Check all that apply.

Friends
Family
Work
Homework
My Classes
Teachers
Extracurricular Activities

Other:

4. When I'm angry I (Check all that apply): *

Check all that apply.

Shut down
Talk with a trusted friend
Listen to music
Get physically aggressive
Talk to a trusted adult
Yell

Other:

https://docs.google.com/forms/d/1o0Dda5tY5dycJRBMG2Kfwm9nBuQGULQUBB72RyqWAzM/edit 1/3
1/13/2020 Freshman Seminar Needs Assessment
5. When I'm feeling sad I (Check all that apply): *
Check all that apply.

Like to be alone
Like to spend time with people who care about me
Listen to music
Cry
Feel unmotivated
Go on a walk/spend time outside

Other:

6. When I am stressed I (Check all that apply): *

Check all that apply.

Avoid the stressor

Talk to a trusted adult
Feel anxious
Make a plan to deal with it
Take a break
Talk with a trusted friend

Other:

7. I can name one trusted adult at school I can go to for help *

Mark only one oval.

Yes
No

8. I can name one trusted adult outside of school I can go to for help *
Mark only one oval.

Yes
No

9. I know one healthy way to care for myself mentally *

Mark only one oval.

True
False

10. I know one healthy way to care for myself physically *

Mark only one oval.

True
False

https://docs.google.com/forms/d/1o0Dda5tY5dycJRBMG2Kfwm9nBuQGULQUBB72RyqWAzM/edit 2/3
1/13/2020 Freshman Seminar Needs Assessment
11. I would like to know more about (Check all that apply): *
Check all that apply.

Stress Management
Mental Wellness
Anger Management
Healthy Relationship Building

Other:

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https://docs.google.com/forms/d/1o0Dda5tY5dycJRBMG2Kfwm9nBuQGULQUBB72RyqWAzM/edit 3/3