Troubled Teen
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StudentsTroubled Teen Questionnaire

Are you the parent of a troubled teen? Many times as parents, we wonder whether or not our teenager is in need of help. The following document is a list that we have put together in order to give you an idea of the seriousness of your teenager's at-risk behavior. This will help you start the process of making the decision whether your child is a candidate for the Turning Winds Academic Institute boarding school for troubled teens.

Does your troubled teen exhibit any of the following behaviors? Check all that apply.

  1. Does your troubled teen fail to complete tasks that require effort regardless of the future importance of the task?
    (e.g. school work)
    Yes No
  2. Does your troubled teen attempt to negotiate and/or manipulate in order to avoid consequences and problems?
    Yes No
  3. Does your troubled teen justify negative behaviors by blaming others?
    Yes No
  4. Is your troubled teen unwilling to recognize the impact of his/her behavior on family and friends?
    Yes No
  5. Does your troubled teen use manipulation and deception in order to change others' points of view?
    Yes No
  6. Does your troubled teen have weekly outbursts or mood swings?
    Yes No
  7. Does your troubled teen avoid participating in family activities and social events?
    Yes No
  8. Does your troubled teen become impatient or easily agitated with others?
    Yes No
  9. Does your teen have an intense fear of gaining weight or becoming fat?
    Yes No
  10. Has there been a recent drop in your teen's performance at school?
    Yes No
  11. Is it difficult for your teen to relate with others or make friends?
    Yes No
  12. Does your teen frequently fail to finish schoolwork, projects or chores?
    Yes No
  13. Does your teen fail to follow through with responsibilities or instructions?
    Yes No
  14. Is your teen forgetful or often viewed as lazy?
    Yes No
  15. Does your teen argue with adults and authority figures?
    Yes No
  16. Is your teen failing one or more courses in school?
    Yes No
  17. Has your teen undergone therapy and/or counseling without results?
    Yes No
  18. Does your teen do dangerous things without considering the consequences, "a daredevil?"
    Yes No
  19. Has your teen been physically abusive to animals?
    Yes No
  20. Is your teen extremely self-conscious?
    Yes No
  21. Does your teen appear depressed, sad, tearful or irritable nearly every day?
    Yes No
  22. Has your teen run away from home? (More than twice)
    Yes No
  23. Is your teen sexually active?
    Yes No
  24. Does your teen engage in self-injurious behaviors and/or threaten to inflict self-harm?
    Yes No
  25. Does your teen use illegal drugs and/or alcohol?
    Yes No

*Note: Once personal information is submitted your teens score will be automatically tallied below and a counselor will contact you within 24 hours.

Parent Name
Address Line 1
City                            State                         Zip
    
Phone               E-Mail
  

Child's Name
Child's Gender  Age
       

I Want to Enroll My Child  Preferred Contact Method
         
How did you hear about us?  Reffered By
    
Comments


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Parent Name
Address Line 1
City
State                         Zip
  
Phone
E-Mail
Child's Name
Child's Gender  Age
       
I Want to Enroll My Child
Preferred Contact Method
How did you hear about us?
Reffered By
Comments

    
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