School Questionnaire

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Student Name
Teacher's Name
How would you describe the student's reading skills?
How would you describe the student's written expression skills?
How would you describe the student's mathematics skills?
What are the student’s strengths?
In which areas does the student seem to struggle?
E.g., completion of assignments, attention to detail, time management
E.g., follows instructions, participates in discussions, stays on task
Do you observe any issues with the student’s ability to focus or sustain attention? If so, please describe.
How well does the student manage their impulses and self-regulate?
Motivation and Effort
E.g., easily makes friends, isolated, conflict with others
How does the student handle frustration, disappointment, or other strong emotions?
If so, please include the number of days missed per school year.
Have any of the following interventions/supports been put in place?
E.g., was the intervention helpful? Is the support no longer needed?
Has the student been suspended? If so, how many times and for what reason(s)?
If so, please describe.
Please add any further details that you would like us to know.