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Appendix E
Sample Guidance and Counseling Program
Evaluation Surveys for Teacher, Student, and Counselor

Missouri Comprehensive Guidance Programs: Linking School Success with Life Success

125

Sample Surveys
The following surveys provide perceptual data from students, teachers, and school counselors regarding the guidance and counseling program. There are three surveys:
1. A look at the guidance and counseling program from the student point of view
2. A look at the guidance and counseling program from the teachers’ point of view
3. A look at the guidance and counseling program from the school counselor’s point of view
These sample surveys are designed for middle school on up but may be adapted as a school sees fit for any grade level.
By quantifying responses and utilizing an EXCEL Spreadsheet, data can be created that will summarize and chart responses for analysis purposes. Schools are encouraged to do this.

Missouri Comprehensive Guidance Programs: Linking School Success with Life Success

126

A Look at the Guidance and Counseling Program
From the Student’s Point of View
INSTRUCTIONS: Circle one category in each of the three demographic areas in the box below.

GRADE: 6

7

8 9 10 11 12

GENDER: Female Male

ETHNICITY: Native American Asian Black Hispanic White

WAYS IN WHICH YOU MET WITH A SCHOOL COUNSELOR:
About how many times has a counselor met with you in each of the following ways?
Since Winter Vacation

For the Entire School Year

Classroom presentations by a counselor

____________

____________

Small-group meetings with a counselor

____________

____________

One-on-one meetings with a counselor

____________

____________

Student/parent/counselor conferences

____________

____________

Student/teacher/counselor conferences

____________

____________

Meetings with a counselor and someone from outside the school

____________

____________

Missouri

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