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Tell Us Your Needs

Needs Assessment Survey

Listed below are various concerns of college students. Review the items and place a check mark next to each item of concern to you. If an item is not listed, then write it in next to Other in the space designated.

FAMILY/RELATIONSHIPS

Parenting
Dating (Finding the right person, Breaking Up)
Marital Problems
Abuse(Spousal, Child)
Sex Education (AIDS awareness, STDs)
Divorce/Separation
Co-Dependency(living with an addicted family member)
Other

FINANCIAL/ACADEMIC

Financial Planning
Study Skills (Time Management)
(Financing School, Getting out of debt)
Anxiety(Math, Test, Public Speaking)
Other

PERSONAL/CAREER

Self esteem
Choosing a major
Interpersonal skills training (Assertiveness)
Choosing a career
Depression
Anxiety (Stress)
Drug Abuse (Alcoholism, Drug Addiction)
Health (Dieting, Exercise)

Other

Would you be interested in attending a seminar or joining a group on one of these topics?

YES
NO

If yes, then what time of day would be most convenient for you?

MORNING
NOON
AFTERNOON
EVENING

 

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