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Week 5 Check-In

Total questions: 10

Worksheet time: 10mins

Name
Class
Date
1.

This week, I've mainly been...

a)

happy.

b)

sad.

c)

lonely.

d)

frustrated.

2.

When I think of my friends....

a)

I'm happy because I know we'll see each other soon.

b)

I reach out to them to talk.

c)

I cry because I don't like being without them.

d)

I don't get sad because I have my family around me.

3.

Lately I feel like I'm sleeping WAY too much.

a)

True

b)

False

4.

How did you sleep last night? 1 star = bad :( 5 star = Great!

a)

b)

☆☆

c)

☆☆☆

d)

☆☆☆☆

e)

☆☆☆☆☆

5.

Which is true?

a)

I know what to do when I'm stressed.

b)

I do NOT know what to do when I'm stressed.

6.

I feel like I can talk to my family if I'm feeling sad.

a)

True

b)

False

7.

I feel like my school is:

a)

doing their best to teach, support and love us.

b)

frustrating me. I need more help.

8.

What do you need to work on as person for remote learning? (Ex: being on time, participating in class discussions, doing the work, ask questions, etc.)

4 lines
9.

Would you like a personal, 1-to-1 check-in with an adult?

a)

Yes - as soon as possible, please.

b)

Yes, but it's not a rush.

c)

No, thank you.

d)

I might - I'll let you know later if I do.

10.

The most important thing I want people to know about me right now is... (don't need to answer if you don't feel comfortable.)

4 lines