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Reflection #14 (5/5)

Total questions: 12

Worksheet time: 14mins

Name
Class
Date
1.

What time did you go to bed last night?

a)

Between 8 and 9

b)

Between 9 and 10

c)

Between 10 and 11

d)

Between 11 and 12

e)

After 12

2.

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

a)

☆

b)

☆☆

c)

☆☆☆

d)

☆☆☆☆

e)

☆☆☆☆☆

3.

How are you doing?


* No one else can see your answers except me.

a)

😁 I 'm great! No real complaints at the moment.

b)

😃 I'm okay. I have a few complaints and/or concerns, but I don't need to talk about them right now.

c)

😐 I'm doing okay, but I have some complaints or concerns and could use someone to talk to.

d)

🙁 I could use someone to talk to (teacher, guidance counselor, dean).

4.

On a scale of 1-10, with 1 feeling very sad and 10 feeling very happy, which range of numbers do you currently fall in?

a)

0-2

b)

3-5

c)

6-8

d)

9-10

5.

How many different muscles do you use every time you talk?

a)

12

b)

32

c)

52

d)

72

6.

Humans have 5 senses. How many senses do sharks have?

a)

5

b)

6

c)

7

d)

8

7.

What emotions do you associate with music?


List at least one.

4 lines
8.

How do you listen to music?


Select all that apply.

a)

On a phone

b)

On a computer

c)

With a radio

d)

On my TV

e)

Other

9.

Do you wear headphones?

a)

ALWAYS!

b)

I MOSTLY wear headphones.

c)

I listen to music out loud more often than not.

d)

I NEVER wear headphones.

10.

I listen to music while I am...


Select all that apply.

a)

exercising

b)

doing my homework

c)

playing video games

d)

practicing mindfulness (like, laying in my bed staring at the ceiling)

e)

going through my daily routines (e.g. getting ready for school or for bed)

11.

Is there a song that has a special meaning to you?


1. What song is it?

2. Why is it special?

4 lines
12.

How would you feel if you could never hear your favorite song again?

4 lines