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28
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1
What Year group are you in?
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Please Select
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
Year 13
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Please Select
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
Year 13
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2
What is your gender?
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Male
Female
I prefer not to say
Other
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3
How Healthy is your diet? (meaning your day-to-day diet, which should include plenty of fruit and vegetables, three regular meals and one hot meal each day)
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I eat regularly and wouldn't dream of having anything unhealthy
I eat healthy meals but also enjoy the odd treat from time to time
I eat two to three meals per day, but they often contain unhealthy foods such as chips or chicken nuggets
I don’t eat regular meals and I rarely eat fruit or veg
I really struggle with my eating, I don’t know what is healthy to eat and I don’t feel good about myself
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4
Do you exercise regularly?
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I am a fitness fanatic and I train at least once per day
I love to exercise, and I do it often but try not to overdo it
I might exercise once or twice per week but don’t see it as a priority
I only exercise as part of my normal day (like climbing stairs or walking to school)
I hate exercise and avoid it at all costs
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5
Do you participate in additional activities in school? For example, sports, drama or something else?
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No
Sometimes
Most weeks
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6
Do you participate in additional activities out of school? For example, scouts, swimming or something else?
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No
Sometimes
Most weeks
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7
Do you usually get a good night’s sleep? (Average of around 8 hours per day)
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Yes
Mostly
No
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8
What is your current daily screen time?
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None
1-2 hours
3-4 hours
5-6 hours
6+ hours
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9
What is your experience with vaping? (Please choose up to 3 options)
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I would never vape. I don’t know what it would do to my body
I have been offered a vape but refused it
I have vaped, but only once or twice
I regularly vape
I do vape but would like to give up
I smoke tobacco or cigarettes
I have been asked to sell vapes
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10
What is your experience with drugs? (Please choose up to 3 options)
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I would never take drugs
People have tried to convince me to take something, but I say no. Its not worth the risk.
People have tried to convince me and I feel I should do the same
I have tried drugs, only once or twice
I have a group of friends and we do it regularly. I have no concerns about this
I think I have a problem with drugs and I need help but don’t know where to turn
I have been asked to sell drugs or carry them for someone
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11
What is your experience with alcohol?
I will not drink alcohol until I’m 18 years old
People tried to convince me to drink something, but I say no
People have tried to convince me and I feel pressured to do the same
I have tried alcohol but not very much or on a family occasion
I have a group of friends and we drink regularly. I have no concerns about this
I think I have a problem with alcohol and I need help but don’t know where to turn
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12
Do you have at least 1 good friend who supports you?
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Yes
No
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13
How well do you get on with those you live with?
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Really well
It’s good most of the time
It can be difficult with my brothers/sisters
Not very well
I’d prefer not to say
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14
Where in your life do you feel like you belong?
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Drag the emoji to the place that best shows how you feel
My home
My School
My community
My friends
My online friendships
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My community
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15
Do you have a trusted member of staff that you would speak to if you needed help?
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Please write the staff name in the 'other' box
My tutor
A class teacher
My Head of year
Guidance and welfare
Another support staff member
Another teacher
Other
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16
Romantic relationships (KS4 and 5)
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I am not currently in a relationship
I like someone and its casual, we’re talking
I have a healthy, equal relationship, I can easily share my opinions and feel respected
I sometimes get annoyed by things that happen, but we can usually work it out
I think it might be unhealthy, I can feel pressured to do what my partner wants
I think it might be abusive, I really don’t have control over what happens
I think I might be too controlling in my relationship
I’d prefer not to say
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17
How happy do you feel?
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I love my life and live it to the full
I have a good life and deal with the ups and downs that it brings
I do seem to struggle with mood when things go wrong
I spend much of my life feeling unhappy
I can’t remember the last time I was happy
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18
How confident do you feel?
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I never doubt anything I do
I am generally confident but I do spend time thinking about some of the things I do
I try to make good decisions but I sometimes worry I’ve done the wrong thing
I worry about all the decisions I make
I am so worried about making decisions that I avoid making any wherever possible
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19
How resilient do you feel?
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If I get knocked down, I get back on track and keep going
I do tend to recover when things go wrong after I’ve figured out how to get over the problem
I do struggle when things go wrong and might feel low for a while
My life seems to be one problem after another and it’s a lot of effort to get back on track
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20
Do you have goals in life?
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I have my future planned out in front of me
I have some idea of what I’d like to do in life and know what steps I need to take
I think I know what to do, but I’m not sure how to achieve it
I often think about the future and it worries me
I’d rather just focus on the here and now
I don’t see the point in thinking about that
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21
When do you feel anxious?
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I never feel anxious, I am comfortable in all situations
I can feel anxious in certain situations, but I cope well. It is a healthy part of life
I often feel anxious, I have trouble relaxing
I think anxiety is negatively affecting my mood and reactions
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22
How do you cope with stress? (Please choose up to 5 Options)
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I don’t tend to get stressed
I exercise to deal with stress. There isn’t much that can’t be fixed by working out
I have learned to use mindfulness. It helps me deal with most of the stresses of life
I can talk about things with family or friends who listen to me
I game or go on social media; I can forget about stress if I do this I don’t know what to do if I feel stressed. It’s scary
If I feel stressed, I might self-harm
If I feel stressed, I use a vape or tobacco
If I feel stressed, I use other substances
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23
Have you ever been bullied at The Blandford School?
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I sometimes get into conflict with certain people
I have had thoughtless comments made to me
I have had unkind comments made to me
I have never been bullied
I have been bullied in the past, but I can deal with it as it’s not a regular issue
I have been bullied in the last year. I have reported this to school
I have been bullied in the last year, I have not reported this to school
I have had discriminatory comments or language used against me
I never have conflict with others
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24
How do you find assessments?
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I know how to revise and I get good results in assessments and exams
I know how to revise but I sometimes get bad results
I know that there are different ways of revising but I’m not sure which one suits me best
I have tried and tried to revise but nothing sticks in my head, no matter how hard I try
I have revised in the past, but I can’t be bothered. I’ll wait until the real exams
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25
What support do you have right now? (Choose all relevant)
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Friends/Family
Mental health support from MHST or CAMHs
Student support worker
Peer mentor
Support from staff in school
Support from someone who visits me in school
Support outside school (such as private counsellor)
Young carers support
I have no support and don’t feel I need it
Other
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26
Would you like to speak with someone from school for more support?
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Yes
No
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27
If you answered yes to the last question (Optional):
First Name
Last Name
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28
Please share any additional thoughts or concerns about your wellbeing (Optional).
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