PARENT/COMMUNITY SEX EDUCATION SURVEY (Sample)
The __________________ School District is in the process of reviewing the sex education/reproductive health education program to better
meet the needs of students as well as the standards of the community. Thank you for taking a few minutes to complete the following survey
and share your thoughts with us.
1. Should the school district include a set of lessons on sex education/reproductive health at the:
(Please circle one response for each level.)
Elementary Level Middle School Level High School Level
Yes No Yes No Yes No
2. If a set of lessons were offered at the age-appropriate grade level, would you allow your child(ren) to participate?
(Please circle one response.)
Yes No I don’t have children currently enrolled in the school district
3. At what grade should each of the following possible sex education/reproductive health topics first be taught?
(Please check one box for each of the following topics.)
Elementary Middle High School Do Not Think
Topics Topic Should Be
K 1 2 3 4 5 6 7 8 9 10 11 12 Taught in School
A. Puberty and Adolescence: Teaches boys and girls about the physical,
emotional, and social changes of puberty and adolescence
B. Reproductive Anatomy: Describes male and female reproductive anatomy
and function.
C. Positive Communication With Family: Encourages students to talk with
their parents and other trusted adults about feelings, relationships, and setting
limits.
D. Positive Friendships: Identifies characteristics of positive friends including
initiating, maintaining, and ending friendships.
E. Child Sexual Abuse: Teaches personal safety concepts, such as good
touch-bad touch, stranger danger and identifying trusted adults who can help.
F. Healthy Dating Relationships: Recognizes healthy and unhealthy
relationships. Differentiates between emotional and physical intimacy, and
limit setting.
G. Abstinence: Discusses benefits of abstaining from sex or ceasing sexual
activity. Teaches assertiveness skills for resisting pressure, such as
communication and refusal.
Michigan Department of Education Last Revised August 9, 2006 Page 1 of 2
Elementary Middle High School Do Not Think
Topics Topic Should Be
K 1 2 3 4 5 6 7 8 9 10 11 12 Taught in School
H. Skills to Avoid Risky Behaviors: Includes developmental skills, such as
decision-making, communication, assertiveness, refusal, and negotiation, to
avoid risky situations.
I. Legal Consequences of Underage Sex: Provides information about the
criminal consequences of underage sexual activity.
J. Pregnancy and Childbirth: Explains how pregnancy occurs, the
importance of prenatal care and how babies are born.
K. Parenting Responsibilities: Explores the responsibilities of parenting
(e.g., economic, physical, emotional, social, and legal) and their impact on
future goals. Provides information on responsibilities to children born in and
out of wedlock.
L. Adoption and Safe Delivery: Provides information an adoption services
and the safe delivery of newborns law.
M. Sexually Transmitted Diseases (including HIV/AIDS): Includes
information about the transmission, symptoms, treatment, and prevention of
sexually transmitted infections, such as chlamydia, gonorrhea, genital herpes,
genital warts, and HIV/AIDS.
N. Risk Reduction: Provides information about condoms as a means to
reduce risk for HIV and other sexually transmitted infections.
O. Contraception: Provides information about birth control methods, such as
condoms, birth control pills, and Depo-Provera and their role in preventing
pregnancy.
P. Sexual Orientation/Identity: Teaches that all students deserve to be
treated with respect (i.e., no name-calling, taunting, bullying) and that some
students self-identify or are perceived to be gay, lesbian, or bisexual.
Q. Harassment, Sexual Assault and Rape: Provides information about the
law, prevention skills, and where to go for help.
R. Other:
4. Please share any additional comments or thoughts.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Thank you for completing this survey. The results will help the district be responsive to parent views.
Michigan Department of Education Last Revised August 9, 2006 Page 2 of 2