Pre-Course Survey

Dear Parents/Caregivers,

Welcome! We're thrilled your child is joining us for "Emotional Super Powers®," a course designed to equip them with essential emotional and relational skills for a thriving life. To best tailor the program and measure its impact, we've created a brief pre-course survey. Your insights into your child's current emotional and social behaviors will provide valuable context, allowing us to understand their starting point and track their progress throughout the "Emotional Super Powers" journey. Your honest feedback will help us ensure every child gets the most out of this transformative experience.

In addition to this initial pre-course survey, we're committed to tracking your child's progress and the lasting impact of the "Emotional Super Powers" program. To do this, we'll be sending out follow-up surveys at several key points: immediately after the class concludes, and then again at 3, 6, 9, and 12 months post-program. These surveys will help us understand how your child has retained and is actively applying the skills they've learned in their everyday lives. Your continued participation will provide invaluable insights into the long-term effectiveness of our program and ensure we're truly making a difference in your child's emotional and relational well-being.

With many thanks,

Your Emotional Super Powers Team

Instructor Name

Parent First Name

Parent Last Name

Parent Phone Number

Parent Email

Child Name

Class Start Date

Child’s Overall Mood: On a scale of 1 to 10 (1 = very negative, 10 = very positive), how would you rate your child's overall mood on an average day?

Frequency of Intense Emotions: In the past week, how often have you observed your child experiencing strong emotions (such as sadness, anger, or anxiety)? (1 = rarely/never, 5 = very frequently)

Emotional Awareness: How well does your child recognize and understand their own emotions? (1 = not at all, 5 = extremely well)

Coping Skills: How effectively does your child manage stress or challenging situations? (1 = not effective at all, 5 = very effective)

Use of Regulation Strategies: How often does your child use specific strategies (e.g., deep breathing, taking a break) to help regulate their emotions? (1 = almost never, 5 = almost always)

Resilience in Recovery: How well does your child bounce back after experiencing disappointment or setbacks? (1 = not well at all, 5 = extremely well)

Frequency of Emotional Discussions (Guardian Involvement): How frequently do you engage in conversations with your child about their feelings and emotions? (1 = rarely/never, 5 = very frequently)

Supportiveness During Emotional Challenges (Guardian Involvement): When your child experiences strong emotions, how supportive do you feel you are in helping them manage these feelings? (1 = not supportive at all, 5 = extremely supportive)

Prior SEL Program Participation: Has your child participated in a social-emotional learning (SEL) program before? (Yes / No)

YesNo

Is there anything else you'd like to share with us?

Military Family?