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  1. Surveys
  2. 2015
  3. May
  4. C
  5. CIS Summer Services
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Exit Survey
 
 
Dear Parent/Guardian,

We would like to take this opportunity to re-introduce Counseling In Schools (CIS) to the PS 43 community. While the school year comes to an end and we start to plan for the summer, CIS would like to invite the PS 43 community to work with us during the summer. We are located in Room 117, and will remain there through August 14th.

CIS has been working with children, families, and school communities for over 25 years, and with the PS 43 community since September, 2014. The philosophy of CIS is to identify, develop, and reinforce the strengths and resilience inherent in everyone. CIS offers individual and group support that addresses the various needs of students. We address factors related to their social and emotional development as well as their academic success . We strive to help them learn the skills necessary to handle the varieties of stress in their lives and reach their full potential. We hope to partner with you in supporting your children, and as such we welcome and encourage your input. With that being said, we are asking you to kindly fill out the short survey to help us plan activities during the summer.

We look forward to working with you!

All our best,
Jasmin Milliner, LMSW
Amaranta Medina-Seabright
 
 
Parent/Guardian
First Name : 
Last Name : 
Address 1 : 
Address 2 : 
City : 
State : 
Zip : 
Phone : 
 
 
Student
First Name : 
Last Name : 
Grade : 
 
 
 
Did your student receive services with us this academic year?
 
Yes
 
No
 
 
 
Would you be interested in your student receiving services with CIS during the summer?
 
Yes
 
No
 
 
 
Please check off one or more of the following that apply:
 
I am interested in more information on summer family activities
 
I give permission for my child to continue working with Counseling In Schools, Inc.
 
I would like to join a parent support group (educational or self-care)
 
 
 
Would your student be interested in individual or group sessions during the summer?
 
Individual
 
Group
 
Both
 
 
 
Please check off the following group(s) that your student may be interested in:
 
Transitional Group (Transition from K->1, 5->6, 8-> HS)
 
High School Prep Support (Provide support and guidance for 8th grade student transitioning to High School)
 
Girls Group (Girls only group to discuss things currently affecting our female youth)
 
Boys Group (Boys only group to discuss things currently affecting our male youth)
 
Pre-K Prep (group that assists in getting incoming Pre-K student ready for the school year emotionally)
 
 
 
Please check off the following group(s) that you may be interested in:
 
Ways to manage job related stressors
 
Effective communication between parent and child
 
Mommy & Me
 
Assistance in dealing with your special needs student(s)
 
 
 
Please select one or more time frames that work best for you and/or your student to receive group services over the summer:
 
Morning: 9am - 10am
 
Afternoon: 12pm - 1pm
 
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