Program Information Survey — Page 1/4

Program Information Survey — Page 1/4

Thinking about the number of children, classrooms, and staff that are currently supported by the MHCs listed previously (regardless of funding source), tell us:

  1. What is your program name?
  1. How many different individual Mental Health Consultants (MHCs) does your program currently work with (for EHS and HS classrooms only)?
    Total MHCs
  2. Does your program regularly work with mental health interns (students) who work with or are supervised by the MHC?
    Yes No (skip to question 6)
  3. How many mental health interns (students) does your program regularly work with?
    Number of mental health interns
  4. About how many hours per week does each intern work?
    Number of hours per week

    If you answered question 5, please skip to question 7.
  5. Which one of the following best describes why you don't work with interns?