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Are you male or female?
 
Male.
 
Female.
 
 
 
How old are you?
 
8-12.
 
13-17.
 
18-22.
 
Older than 22.
 
 
 
Have you ever been bullied in School?
 
Yes.
 
No
 
 
 
Had your teacher ever intervened while you were being bullied?
 
Yes
 
No
 
 
 
Have you ever approached your teacher against your bullying?
 
Yes
 
No
 
 
 
Have you ever talked to your parents against your bullying?
 
Yes
 
No
 
 
 
Did your teachers/parents ignored or intervened about your bullying?
 
Intervened.
 
Ignored.
 
 
 
Did bullying enhanced a positive development in you?
 
Yes.
 
No.
 
 
 
Do you suffer from any disorder due to bullying?
 
Depression.
 
Anxiety.
 
Low Self-Esteem.
 
Increased susceptibility to illness.
 
Other
 

 
 
 
Have you seen a doctor due to complications from bullying?
 
Yes.
 
No.
 
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