JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
DSS Student Survey January 2020
A survey created to gather accurate information about the level of stress students at DSS experience in their lives.
Sign in to Google
to save your progress.
Learn more
I am currently:
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old
19 years old
Clear selection
My gender is:
Your answer
My sexual orientation is:
LGBTQ2+
Straight
Questioning/I don't know
Clear selection
The extent that going to school causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
The extent that staying at school at lunch causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
The extent that being with my friends causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
The extent that keeping up with social media causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
The extent that doing academic course work causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
The extent that being with my family causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
The extent that being away from my family causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
The extent that thinking about the future causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
The total hours that I work at one or more part-time jobs is/are ___________ and the extent that working at my job(s) causes me stress is:
1 minimal stress
2
3
4 high stress
zero hours per week
1-4 hours per week
5-10 hours per week
11-15 hours per week
16-20 hours per week
21-25 hours per week
over 25 hours per week
1 minimal stress
2
3
4 high stress
zero hours per week
1-4 hours per week
5-10 hours per week
11-15 hours per week
16-20 hours per week
21-25 hours per week
over 25 hours per week
The extent that my gender identity causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
The extent that my sexual orientation causes me stress is:
hardly ever
1
2
3
4
almost always
Clear selection
At school, I frequently feel a high level of stress (check all that apply)
walking into the building
during a class lesson
walking down the hallways between classes
when getting assessment feedback
when an assignment due date is announced
when asked to answer a question in front of my peers
when asked to share my opinion in front of my peers
when looking at my incomplete assignments on Student Connect
when looking at my grades on Student Connect
while attempting to complete a test
when participating in school based extra-curricular activities (sports, theatre, music or clubs)
The level of stress that I usually experience when in ____________ is:
1 minimal stress
2
3
4 high stress
Academy
Applied Arts
English
Fine Arts
Language Studies
Math
PE
Science
Social Studies
1 minimal stress
2
3
4 high stress
Academy
Applied Arts
English
Fine Arts
Language Studies
Math
PE
Science
Social Studies
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Delta School District.
Report Abuse
Forms
