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Student's Mental Health Survey

Total questions: 15

Worksheet time: 13mins

Name
Class
Date
1.

How do you feel about remote learning?

a)

Love it

b)

Like it

c)

It is okay

d)

I dislike it

2.

How do you feel about face-to-face class instructions?

a)

Love it

b)

Like it

c)

It is okay

d)

I dislike it

3.

How do you feel about hybrid?

a)

Love it

b)

Like it

c)

It is okay

d)

I dislike it

4.

Have you been able to get ahold of your teacher when needed when you are remote?

a)

All the time

b)

Sometimes

c)

Not when it is convenient for me

d)

Never

5.

You can you go to talk about your school experiences?

a)

Parents

b)

Teachers

c)

Friend

d)

Sibling

6.

What causes you stress?

a)

Not being able to complete your assignments

b)

Not understanding the assignments

c)

Not having the correct instructions to complete

d)

Assignments not being posted timely

7.

What tools would help you be more successful with online learning?

a)

Group options if available

b)

Scheduled time with a teacher each week/day

c)

Chat rooms

d)

Immediate feedback

8.

Do you ever feel lonely ?

a)

All the time

b)

Sometimes

c)

Not often

d)

Never

9.

Would you participate if a virtual lunch group was offered?

a)

Yes

b)

Maybe

c)

Occasionally

d)

No

10.

Would you participate in online games with other students?

a)

Yes

b)

Maybe

c)

Sometimes

d)

No

11.

Would you participate in a book club?

a)

Yes

b)

Maybe

c)

Not at this time

d)

No

12.

How much time do you feel you can stay online in one day?

a)

6 hours

b)

4 hours

c)

2 hours

d)

1 hour

13.

Do you want the option to redo an assignment?

a)

Yes

b)

Sometimes

c)

Not really

d)

No

14.

Explain how remote learning works or doesn't work for you?

4 lines
15.

Explain if you would like to be remote full-time, hybrid full-time or in-class full-time?

4 lines