Surveys

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Teen Bullying Survey

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1) What is your Current Age?


2) What gender do you identify as?


2b) If you chose OTHER from above, please specify how you identify.


3) What is your sexual orientation?


4) What is your ethnicity? (optional)

5) Have you ever experienced bullying?


5b) If you answered YES, how many times did the bullying happen?


5c) If you answered More than Once, please specify the number of incidents.


6) How old were you at the time the bullying happened? (Please check ALL that apply)


7) Where did the bullying take place? (Please check ALL that apply)


8) What type of bullying happened? (Please check ALL that apply)

9) Did you tell someone about the bullying incident(s)?


9b) If you answered NO, then why not?


9c) If you answered YES, then who did you tell?


10) How did you respond to the bullying incident(s)? (Please check ALL that apply)


11) Please explain how you felt when the bullying happened?

12) Did you receive any help to deal with the bullying incident(s)?


12b) If you answered NO, then why not?


13) Where did you receive help from to deal with the bullying? (Please check ALL that apply)


14) In what way was the support that you received helpful?


14b) If the support that you received was not helpful, what would have been helpful for you when the bullying occurred? (e.g., counseling, talking to family/friends)


15) At any time, were you able to find information about services and resources that deal with bullying available in your community?


15b) If you answered YES, where did you find the information? (Please check ALL that apply)


15c) If you checked Referral above, please specify where?


15d) If you checked Website above, please specify where?


15e) If you checked Other above, please specify where?