The code block below illustrates how one might use # and // as comments in your logic and calculations.

# Text can be put here to explain what the logic/calculation does and why.
if ([field1] = '1' and [field2] > 7,

	// This comment can explain what the next line does.
	[score] * [factor],

	// Return '0' if the condition is False.
	0
)

Working...

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

FCHD School Health Survey

Purpose: To assess parent/caregiver satisfaction regarding the care of Fairfax County Public School students conducted in the health room by staff of the Fairfax County Health Department School Health Program.

Time required: The survey takes 15 minutes to complete.

Benefits: Parental responses are analyzed and will help contribute to the improvement of School Health services.

Risks: There are no identifiable risks.

Confidentiality: The survey responses are anonymous and only the school is identified. Responses are retrieved by the managerial staff at the Fairfax County Health Department with access to survey reports which are password protected.

Participation: Participation is completely voluntary.

Please complete one survey for each of your students.

What school does your child attend? (drop down list)

* must provide value

Does your child have an ongoing health condition as noted by you on the Health Information Form?
Yes or No
If you answer "No" to this question,
skip to Question 7.

* must provide value

Yes

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Did the School Public Health Nurse meet with you to develop a health care plan for your child's health condition?

If no, go to question 7.

If yes, go to question 4.

Yes, we met and developed a plan.

No, my child does not need a health care plan.

I'm not sure.

reset

How satisfied are you with the process of planning your child's health care plan with the School Public Health Nurse?

Very satisfied - The process was clear, and my concerns were fully addressed.

Somewhat satisfied - The process was helpful, but there is room for improvement.

Somewhat dissatisfied - The process was unclear or did not fully meet my child's needs.

Very dissatisfied - The process was confusing or did not address my child's needs at all.

I'm not sure.

reset

To what extent do you agree with the following statement: "Having a health care plan in place has helped my child succeed in the school setting."

* must provide value

Strongly Agree

Agree

Disagree

Strongly Disagree

I'm Not Sure

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How can the health care plan be improved?

No improvements are needed; the plan works well.

Better coordination between the School Public Health Nurse and school staff.

More frequent plan reviews and updates with parents.

Clearer instructions for parents to support plan or complete authorization forms.

Other (please specify):

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A School Health Aide (SHA) is a trained staff member for the health room who provides care for sick or injured students following set guidelines. Did you or your child have contact with the school health aide?

* must provide value

Yes

Not sure

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Strongly Agree

Agree

Disagree

Strongly Disagree

I'm Not Sure

The School Health Aide responded respectfully and promptly to my concerns about my child.

* must provide value

reset

The School Health Aide responded respectfully and promptly to my child's needs.

* must provide value

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A Public Health Nurse is a registered nurse who assesses health conditions, develops health care plans, trains staff, connects students and their families to health resources, and provides health education. Did you or your child have contact with the Public Health Nurse?

If no, go to question 12.

* must provide value

Yes

I Don't Know

Not applicable

reset

Strongly Agree

Agree

Disagree

Strongly Disagree

I'm Not Sure

10a

The Public Health Nurse responded respectfully and promptly to my concerns about my child.

* must provide value

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10b

The Public Health Nurse responded respectfully and promptly to my child's needs.

* must provide value

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Why did you or your child have contact with the Public Health Nurse? Please select all that apply.

Questions or follow up for a new or ongoing health condition

To develop a plan of care for my child's health condition in the school setting

Follow up for an illness or injury

Medication issues

Connection with a health or community resource

Attended a health fair or health education class at my child's school

Other (please describe):

Which of the following would you like to have shared with you? Please select all that apply.

Health messages in school newsletter

Health promotion activity or presentation in class

Presentation on mental health or substance abuse

Resources of community organizations

Food pantry resources

Dental resources

Other (please describe):

Overall, I am satisfied with the care my student receives in the health room.

* must provide value

Strongly Agree

Agree

Disagree

Strongly Disagree

I'm Not Sure

I believe my student can get their health needs met in the health room.

* must provide value

Strongly Agree

Agree

Disagree

Strongly Disagree

I'm Not Sure

reset

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.