Describe your grades and check-in goals. Makeform creates an age-appropriate student well being survey covering belonging, safety, stress, and support.
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Sample prompts for the builder
Choose a prompt, adjust it, or send it into the builder. Each structure is an example.
Audience
Middle and high school students
Format
Two-minute pulse survey with support request
Prompt size
292 chars
Example survey structure
Two-minute pulse survey with support request
How often did you feel calm and ready to learn this week?
How manageable did your schoolwork feel?
I felt included by other students
I have an adult at school I can talk to
Would you like a counselor to contact you?
Suggested routing tags
Review today
Counselor follow-up
Schoolwide trends
Keep one time frame, such as “during the past two weeks,” across all ratings.
Step 1
Ask
brief, age-appropriate questions
Step 2
Signal
belonging, safety, stress, and support
Step 3
Route
requests reach the right school contact
Step 4
Review
patterns guide the next check-in
A useful student pulse
Separate belonging, safety, relationships, workload, and help-seeking so staff can see distinct patterns.
Ask about safety, inclusion, and trusted-adult access separately to reveal which area needs attention.
Reuse one labeled frequency or agreement scale and keep the response period visible.
Collect the student's preferred adult and time, then notify the designated team.
Four practical survey modes
Named check-ins allow follow-up; anonymous climate surveys reveal trends but cannot identify a student.
A short check on school mood, workload, belonging, and contact requests.
Grade band and optional comments reveal patterns without identity fields.
Ask new students about routines, friendships, adjustment, and desired support.
Repeat core questions before and after a student-support initiative.
Survey workflow
Start with the decision, then choose identity settings, questions, and routing that fit it.
Specify grades, cadence, topics, identity settings, and who receives help requests.
Remove jargon and double questions. Define the time frame and test every response choice.
State who sees answers, their use, and whether follow-up is possible. Show existing urgent-help instructions separately.
Share the link, route contact requests, and compare patterns without treating scores as a diagnosis.
Choose the response model
Tell students what is collected and what staff can do with a response.
Field guide
Use six focused sections, optional open text, and a clear support route.
Emotional experience
Use student-friendly wording about a specific recent period so repeat check-ins are easier to compare.
Belonging & peers
Ask separately about acceptance, peer respect, participation, and having someone to talk to.
Safety & respect
Ask about safety in different school spaces, reporting knowledge, and confidence in adult response.
Learning & workload
Ask about manageable workload, concentration, and access to academic help without overinterpreting one score.
Trusted adults
Ask whether a trusted adult is available, listens, and can be contacted in the student's preferred way.
Follow-up choice
Offer direct contact on named surveys; show separate support channels on anonymous surveys.
Related tools
Build focused feedback, needs, attendance, and incident forms alongside the main check-in.
Collect views about teaching, services, activities, and learning.
Open toolExplore perceptions of climate, instruction, belonging, and support.
Open toolIdentify technology and access barriers affecting participation.
Open toolRecord attendance separately from well being responses.
Open toolDocument incidents for the school's review process.
Open toolAdd family perspectives on communication, climate, and support.
Open toolFAQ
Answers for school teams designing a useful check-in.
It is a school check-in about emotional experience, belonging, relationships, safety, workload, trusted adults, and desired support. It reveals self-reported patterns, not a diagnosis.
Ask separately about recent emotional experience, belonging, peer respect, safety, workload, trusted adults, and help-seeking. Use one scale, optional open text, and a support choice.
Use names for individual follow-up and anonymity for group-level climate feedback. Explain the choice: an anonymous response cannot identify a student for contact.
Keep a frequent pulse to a small rating set, optional comment, and support request. A termly survey can cover more areas under clear headings.
Yes. Use concrete wording and fewer choices for younger students. Keep core concepts stable for comparison and test comprehension before publishing.
On a named form, ask whether contact is wanted, the preferred staff member, and a suitable time. Route it to the designated team and show urgent-help instructions separately.
Review patterns by question, grade, and period; read comments in context; and document actions. Do not treat one rating as proof of a condition.
Yes. Makeform is unlimited free for generating, editing, publishing, and collecting responses. The paid tier removes the Makeform badge.
Make every check-in easier to answer and act on.
