Geisel Counseling Survey: Continuing Students

Geisel Counseling is committed to the confidentiality of all students we serve. All information shared within this program is treated with respect by the Geisel Counselors and no student identifying information is shared with the Medical School.

M1 M2 M3 M4 TDI Other: (e.g.)Academic Scholar/Research Year, MD/PhD, MD/MBA Prefer not to say
(* required info)
*
  • Yes
  • No
*
  • Yes
  • No
*
  • Extremely satisfied
  • Somewhat satisfied
  • Neither satisfied nor dissatisfied
  • Somewhat dissatisfied
  • Extremely dissatisfied
Please explain your selected response for the question above. *
*
  • 0 - would not recommend at all
  • 1
  • 2
  • 3
  • 4
  • 5 - might recommend
  • 6
  • 7
  • 8
  • 9
  • 10
*
  • Preventive/Improve Wellbeing
  • Stress related to Medical School
  • Stress NOT related to Medical School
  • Adjustment Concern (Loss, Grief, Accident, Illness or Injury)
  • Mood Concern
  • Anxiety Concern
  • Attention /Concentration Concern
  • Academic Concern
  • Sleep Concern
  • Eating Concern
  • Substance use Concern
  • Relationship Concern
  • Other
*
  • Extremely important
  • Somewhat important
  • Neither important nor unimportant
  • Somewhat unimportant
  • Extremely unimportant
*
  • 1
  • 2-4
  • 5-8
  • More than 8
*
  • In-Person at Counseling Associates/Buck Rd or The Nugget
  • Telephone
  • Zoom
*
  • M1
  • M2
  • M3
  • M4
  • TDI
  • Other (e.g.) Academic Scholar/Research Year, MD/PhD, MD/MBA
  • Prefer not to say
Is there anything else you would like to share about your overall well-being as a medical student or your
thoughts/experience seeking support? *
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