Bullying Survey
THE ANSWERS TO THESE QUESTIONS ARE PRIVATE. Your name will not be included in this form. We need your honest opinion. Please check the boxes and leave any comments at the end of this survey that you would like to share.
Gender *
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Age *
Your answer
What is bullying? Examples:
Bullying is when someone is being hurt either by words or actions on purpose, usually more than once, feels bad because of it, and has a hard time stopping what is happening to them.


VERBAL BULLYING includes: Teasing, Name-calling, Threatening to cause you harm, Taunting

SOCIAL BULLYING includes: Leaving someone out on purpose, Telling others not to be friends with someone
Spreading rumors about someone, Embarrassing someone in public

PHYSICAL BULLYING includes: Hitting/Kicking/Pinching, Spitting, Tripping/Pushing, Taking or breaking someone’s things, Making mean or rude hand gestures

CYBER BULLYING includes: Constant mean texts, Hurtful comments on Facebook or other Social Platforms, Prank calls

Being Hurt by Words or Actions and You Have a Hard Time Stopping What is Happening
1. Have you ever been bullied in Durkin Park School? *
Required
2. If Yes, how recently? *
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3. Were you bullied by a group of children or someone on their own? *
Required
4. Were other students present to witness this?
5. How were you bullied? Check all that apply.
6. Where did it happen? *
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7. How did it make you feel?
8. Did you tell anyone?
9. If No, what stopped you from telling someone?
Your answer
10. If Yes, who did you tell?
11. What happened after you told someone?
12. Do you feel like school takes bullying seriously? *
13. If Yes, what does the school do to stop bullying?
Your answer
14. Have you ever bullied anyone? *
Required
15. Have you ever witnessed someone being bullied? *
Required
16. If Yes, what did you do?
17. Please tell us anything you would like share about bullying. Such as need help helping someone that is being bullied or you are being bullied.
Your answer
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