______________ Middle School Student Needs Assessment
Student Instructions: Our school wants to ensure that we develop and provide programs that meet student needs.
Please answer the questions on this survey as honestly as possible. Only you will know the answers you have
provided since no specific student information is collected for this survey. Please select the level to which you agree
or disagree with each statement on the survey. Thank you for helping the school to better meet your needs.
1. Please answer the following questions about you. What is your grade level?
_____5th Grade
_____6th Grade
_____7th Grade
_____8th Grade
2. What is your gender?
_____ Female
_____ Male
3. What is your race/ethnicity?
_____ Asian/Pacific Islander
_____ Black/African American
_____ Hispanic
_____ Mixed Race
_____ Native American
_____ White/Caucasian
Answer each statement and check how true it is.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
I need help making friends.
I need help fitting in at school.
I need help dealing with peer pressure.
I need help improving communication skills.
I need help getting involved in school activities.
I need help dealing with dating and relationship issues.
I need help dealing with drug or alcohol abuse.
I need help developing self confidence.
I need help dealing with being teased or bullied.
I need help getting along with other students.
I need help getting along better with family members.
I need help dealing with sadness or depression.
I need help dealing with suicidal thoughts.
I need help dealing with the loss of a loved one.
I need help dealing with parental divorce or separation.
I need help dealing with anger.
I need help dealing with stress.
I need help developing skills for resolving conflicts.
I need help being more organized.
I need help managing my time better.
I need help improving study skills.
I need help reducing test anxiety.
I need help improving test taking skills.
Strongly
Agree
Agree
Neither
Agree or
Disagree
Disagree
Strongly
Disagree
______________ Middle School Student Needs Assessment
Answer each statement and check how true it is.
Strongly
Agree
Agree
Neither
Agree or
Disagree
Disagree
24. I need help understanding what my test scores mean in
relation to school and career planning.
25. I need help understanding the best career options for
me.
26. I need help planning my options for after high school.
27. I need help understanding my learning style to improve
how I learn.
28. I need help understanding high school graduation
requirements.
29. My school counselor is available to me when I need to
see him/her.
30. I feel comfortable going to see my school counselor
when I need help with SCHOOL concerns.
31. I feel comfortable going to see my school counselor
when I need help with PERSONAL concerns.
32. The school is involved with helping to develop my
education plan.
33. My school counselor has helped me understand my
WESTEST scores.
34. My school counselor has helped me understand my
EXPLORE scores.
35. My school classes keep me interested in the topic.
36. I like coming to school.
37. My teachers are willing to help me when I have
questions.
38. I understand why I take the WESTEST.
39. I understand why I need a good education.
40. Graduating from high school is important to me.
41. Continuing my education after high school is important
to me.
42. Please list any other concern or need with which you personally would like to receive additional help.
Strongly
Disagree