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* 1. School:

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* 2. Age:

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* 3. I believe the services I have received have helped me to....

  Strongly Agree (1) Agree (2) No Opinion (3) Disagree (4) Strongly Disagree (5)
Improve my attendance
Do better in school
Cope better when things go wrong

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* 4. The skills I learn have allowed me to...

  Strongly Agree (1) Agree (2) No Opinion (3) Disagree (4) Strongly Disagree (5)
Be more successful in classes
Improve my communication
Better control my behaviors in school
Get along better with others in school

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* 5. From my sessions with my therapist I have gained knowledge of how to improve my physical and emotional well-being.

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* 6. I have attempted to improve my physical and emotional well-being.

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* 7. What could be done to improve this program to help you be more successful at home and school?

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