Bully Survey – Big Dave's Safe Station

Welcome to your Bully Survey

Please tick the boxes that apply to your own circumstances

First Name Only

1. Do you: Try to hurt other kids on purpose?

Yes

2. Do You: Call other kids names?

Yes

3. Do You: Say things to get a reaction-such as being scared or upset-out of another kid?

Yes

4. Do You: Gossip about other kids or try to make them look bad?

Yes

5. Do You: Tease other kids about how they look or act?

Yes

6. Do You: Start rumors about other kids?

Yes

7. Do You: Want other kids to be afraid of you?

Yes

8. Do You: Threaten to humiliate other kids on purpose?

Yes

9. Do You: Hit, push, or shove other kids?

Yes

10. Do You: Leave kids out of games or groups on purpose?

Yes

11. Do You: Encourage other kids to be mean with you?

Yes

12. Do You: Hurt or be mean to other kids mostly when adults are not around?

Yes

13. Do You: Take or ruin other kids' stuff?

Yes

14. Do You: Enjoy it when you make other kids upset?

Yes

15. Do You: Blame other people for your actions?

Yes

16. Do You: Think it's cool when you laugh at others?

Yes

17. Do You: Enjoy it when other kids are scared of you?

Yes

18. Do You: Think that some people deserve to be hurt or teased?

Yes

19. Do You: Send mean or threatening messages by text, social media, or other technology?

Yes

Please fill in the comment box below.

Do you think it is OK to be a bully and if you have answered Yes to even just one of the questions please take the time to think about your actions and use this as an opportunity to learn about the impact it has others. At some point in life you might well find yourself being bullied at school, in the home, at work and other places. If you would like to change this behaviour then we can help you.

Thank you for helping us to understand more by completing this short survey, there will be no follow up on your answers but we do hope that you take the time to think about why you do or have done this in the past and think about the effect it has on others and be honest with yourself.