Online toxicity/Cyberbullying Assessment
Taking an assessment is a brave first step and we're here for you. These questions describe common experiences with cyberbullying and/or online toxicity. This assessment is here to help you see if you or a loved one may need treatment. Some of these questions may be sensitive. Please be honest and answer to the best of your ability. There are no right or wrong answers, the questions are here to help you.

Note: We collect responses to improve our clinical services, but we do not ask you for any private information.
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Email *
Are you answering these questions for yourself or a loved one?
Please enter your age *
How do you identify? *
Which race and ethnicity do you identify as? *
Quiz Questions
We know these questions may be sensitive. Please answer to the best of your ability. There are no right or wrong answers
1. Does online toxicity and/or harassment and/or cyberbullying create unwanted or negative emotions for you? *
2. Does online online toxicity and/or harassment and/or cyberbullying affect your daily life? *
3. Has online toxicity and/or harassment and/or cyberbullying you have experienced ever affected your relationship with others? *
4. Have you ever said something online that was used out of context to harass you (bully you emotionally or physically)? *
5. Has someone made an inappropriate meme out of you and/or about you and posted  it online? *
6. Have you skipped school, work, or social gatherings due to online toxicity and/or harassment and/or cyberbullying? *
7. Has your work or school performance been affected due to online toxicity and/or harassment and/or cyberbullying? *
8. Have you ever experienced online toxicity and/or harassment and/or cyberbullying? *
9. Have you experienced any negative changes to your physical health due to online toxicity and/or harassment and/or cyberbullying? (e.g. weight gain or loss, physical pain, etc.) *
10. Do you feel you are being targeted for online toxicity and/or harassment and/or cyberbullying because of any of these reasons: Your age, sex, sexual orientation, race, ethnicity, physical abilities, appearance or religious/spiritual beliefs? *
11. Have you continued to think of the online toxicity and/or harassment and/or cyberbullying comment and felt depressed or anxious that lasted more than a few minutes? *
12. Has the online toxicity and/or harassment and/or cyberbullying you experienced made it difficult for you to go to sleep or go about your regular daily activities? *
A copy of your responses will be emailed to the address you provided.
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