Coordinated School Health - Coordinated School Health Survey

* School List

Gender

Male Female

* What is your age?

How do you feel about your weight?

I am at a healthy weight.
I am at an unhealthy weight.
I am unsure of my weight.

I am employed by Washington County Department of Education.

Yes
No

Do you participate in any wellness activities (exercise, eating healthy, etc.?)

Yes
No

Please list any wellness activities you participate in.

Did you join your school's Healthy School Team?

Yes
No

Are you a diabetic?

Yes
No

Do you have any heart problems?

Yes
No

Do you have any other health problems?

Yes
No

Please list any other health problems.

Are you currently trained in CPR?

Yes
No

Have you had anyone come into your classroom and present a health topic to your students?

Yes
No

Please list all topics taught and by whom.

Do you teach any health topics with your curriculum?

Yes
No

Please list any health topics you teach.

Does your class mentor or teach other students any health-related material?

Yes
No

Please list any mentoring.

* Do you do any physical activity in the classroom with your students?

Yes
No

Please list any physical activity.

Did you visit your school clinic/LPN (K-8) this school year?

Yes
No

What services did you receive?

Did you visit an RN at one of the high schools this school year?

Yes
No

What services did you receive?

Did you see a Nurse Practitioner for an illness this school year (at JES, DBHS, or DCHS?)

Yes
No

What services did you receive?

Thank you for completing our yearly survey. Please call our office with any questions or concerns, (423) 434-4920.