PARENT questionnaire: GETTING TO KNOW YOU

Student Name:

First Name

Last Name

Date:

YYYY

High School Name:

School District:

(if applicable - public school students only)

Please take a few moments to provide us with information that will allow us to best serve your family throughout the college counseling process. Thank you!

Name of Parent Completing Form (Primary):

First Name

Last Name

Primary Parent Email:

Primary Parent Cell:

Our team typically sends lots of reminders throughout the college counseling process, and detailed meeting recaps after each appointment. We prefer to copy a parent on these emails in order to keep the lines of communication open. However, some parents do not like to read all of the details and would prefer that we only contact them on a "need to know" basis. What is your preference?

Secondary Parent Name:

First Name

Last Name

Secondary Parent Email:

Secondary Parent Cell:

Many parents have multiple email addresses (i.e. work and personal). To prevent confusion down the line, are there any other email addresses that you would like us to use for either parent? If so, please share them:

During the winter, we occasionally open our office on days when Fairfax County is closed for inclement weather. Some parents like to take advantage of these days in order to get scheduled meetings out of the way without missing academic or athletic obligations. As such, we often send emails to families with last-minute availability for meetings. Would you like to be added to our "snow day list"?

Yes

Do we have permission to text message or call your student if needed? For example, when trying to track down a missing assignment, or if the student is late for a meeting?

Yes

If so, what is your student's cell phone number?

Do we have permission to text message both parents if needed?

Yes

Is there another number that we should have on file to reach you if needed? For example, a work number, a home number, or both?

What is the best mailing address to use if we need to send something to your student?

Please provide information for at least one emergency contact person in case your student has an emergency while meeting with us alone and we cannot reach either parent:

Does your student have any medical issues about which we should be aware? For example, epilepsy.

Does your student have any religious or cultural needs about which we should be aware? For example, fasting during Ramadan.

It is helpful for us to have a sense of who else is living in the home and provide context for your student's experience. Please list the names, ages, and grades (if applicable) of any siblings.

As you may have seen during the consultation process, we keep our office stocked with snacks! Does your student have any allergies about which we should be aware? We try to make sure that everyone has an option, regardless of dietary restriction!

Are there aspects of your student's personality, particularly in regard to motivation, that you would like to share with our team? For example, many teenagers respond well to regular reminders about pending assignments, but others might feel suffocated by this approach.

Are there any sensitive family or personal issues with which your student has dealt or is currently facing? Often times these come up during the essay writing process and it can be helpful to know in advance. These can include eating disorders, social struggles, custody issues, and so on.