Follow-Up Survey: Take a Day Time Break

Name*

First Last

Email*

School*

School Address*

Street Address City State ZIP Code

1. Have you used or do you plan to use the TAKE A DAY TIME BREAK high school program? (If NO, please share this survey with the teacher who used or plans to use the program.)

Yes
No

2. How likely are you to recommend the TAKE A DAY TIME BREAK high school program to other teachers

Very Likely
Likely
Somewhat Likely
Not Likely

3. Please evaluate these components of the TAKE A DAY TIME BREAK high school program.

Teacher's Guide

Teacher Resource Sheet

Activity Sheets

Take-Home Letter for Families

4. Did you download and distribute the take-home letter?

Yes
No

5. Did your students build skills and/or knowledge as a result of this program?

Yes
I'm not sure
No

6. Overall, how would you rate the usefulness of the TAKE A DAY TIME BREAK high school program?

Extremely Useful
Very Useful
Somewhat Useful
Not Useful

7. How important are topics such as mental health in planning your school curriculum?

Very Important
Important
Somewhat Important
Not Important

8. I would like to see more lessons focused on the following areas: (check all that apply)

Mental Health Concerns
Coping Strategies
Resilience
Mental Wellness Activities
Emotional Skills
Other (provide details below)

If you checked OTHER, please provide details here.

9. Are you interested in receiving free educational materials from YMI in the future?

Yes
No

If YES, please tell us the types of materials you would most likely use/want.

10. Have you visited YMI’s website (www.ymiclassroom.com) to download any other teaching materials?

Yes
No

If YES, which materials have you downloaded?

Please share any additional comments or suggestions: