Teacher Survey

What you observe and do is important to us!

Survey: TEACHER

What is your first name? *

What is your last name? *

What is your email address? *

What is your school's name? *

How many students do you have? *

What state/province are you in? *

On an average day, how many minutes of teaching time do you lose to peer-to-peer behavioral issues? *

How much additional time do these behaviors take? *

(This includes making referrals, calling parents, teaching appropriate behavior later, filling out PBIS forms, etc.)

How would you rate your student-to-student relationships and behaviors generally? *

1 (Not So Good)

10 (Terrific)

How many students in your class are of concern to you because of their sense of isolation or belief that they aren't liked? *

How many students in your class are of concern to you because of their anger or aggression toward peers? *

How many minutes per day are you frustrated because of student behavior? *

If there were one social/emotional issue you would like a program to be able to address for your students, what would it be?

(Please give us your response, but also please do track any other indicators that would be helpful for you or for us!)

What else would you like us to know?

5 Radical Minutes delivers increased connection in a simple yet insightful manner. This daily practice teaches you new rules of engagement: to listen more openly, to reflect more quietly, and to respond more thoughtfully.

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