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School Bullying Survey
*1.
Do you understand what school bullying is?
Yes
No
*2.
During the last month, have you been bullied at the school?
Yes
No
*3.
During the last month, have you seen someone else be bullied at the school?
Yes
No
4.
During the last month, how many times has someone pushed you, shoved you, tripped you, spit on you, or destroy your property on purpose?
Never
Once
2 - 3 times
More than 3 times
5.
During the last month, how many times has someone made fun of you or insulted you?
Never
Once
2 - 3 times
More than 3 times
6.
During the last month, how many times has someone spread rumors or say/post hurtful things about you?
Never
Once
2 - 3 times
More than 3 times
7.
During the last month, how many times has someone threatened you with harm?
Never
Once
2 - 3 times
More than 3 times
8.
During the last month, how many times has someone left you out of or wouldn't let you join activities on purpose?
Never
Once
2 - 3 times
More than 3 times
9.
During the last month, how many times has someone tried to make you do things you didn't want to do?
Never
Once
2 - 3 times
More than 3 times
10.
Do you have any other comments, questions, or concerns?
Not at all likely | Extremely likely |
0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
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