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Questionnaire template

School Concern Report

Lets parents, students and staff report a school issue, rate its seriousness and impact, and request follow-up.

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Other · Complaint forms. All Other templates

Questions in this template

About You

  1. Use this form to tell us about a problem you have experienced at school. We read every report and use them to put things right.

  2. What is your connection to the school?

    Choose one from a list:

    • Parent or guardian
    • Student
    • Teacher
    • Administrative staff
    • Other

  3. What is your other connection to the school?

    Condition: Shown when Other is selected

    Open answer

  4. What is your name? (optional)

    Open answer

Type of Issue

  1. Which areas of school life does the issue concern? Select all that apply.

    Choose any that apply:

    • Teaching and lessons
    • Administration
    • Buildings and facilities
    • Extracurricular activities
    • Student wellbeing
    • Other

  2. Tell us a little more about the areas you selected.

    Condition: Shown when at least one area is selected

    Open answer

What Happened

  1. Describe the issue, including where and when it happened.

    Open answer

  2. Have you raised this issue with the school before?

    Choose one:

    • Yes
    • No

  3. How did the school respond when you raised it?

    Condition: Shown when the issue was raised before

    Open answer

Impact of the Issue

  1. How serious do you consider this issue to be?

    Choose one:

    • Not at all serious
    • Slightly serious
    • Moderately serious
    • Very serious
    • Extremely serious

  2. How much has the issue affected each of the following?

    • Your studies or your work
    • Your relationships with others at school
    • The reputation of the school
    • Your experience of the school as a whole

    For each row: choose one:

    • No impact
    • Low impact
    • Moderate impact
    • High impact
    • Very high impact

Putting It Right

  1. What outcome would you consider a fair resolution?

    Open answer

  2. Would you like the school to follow up with you?

    Choose one:

    • Yes, as soon as possible
    • Yes, but it is not urgent
    • No, I only want to make the school aware

  3. Is there anything you would like us to know about how we follow up?

    Open answer

  4. How can we contact you? Please give an email address or phone number.

    Condition: Shown when a follow-up is requested

    Open answer