Bullying Questionnaire


Bullying questionnaire is a series of questions designed to investigate bullying in schools, work places and institutions. This is done in order to maintain proper decorum and harmony at the work place and prevent harassment, maltreatment and discrimination against anyone. Bullying questionnaire can be different for different people e.g. in schools there can be student questionnaire, teacher questionnaire or victim questionnaire.

Bullying Questionnaire Sample

Name:               __________________________________________________________________

Grade:               ______________________           Gender:        ________________________

  1. How many times in the past week have you been bullied in your school?

a)    None

b)    Once

c)     More than once

d)    Many times

  1. How secure do you feel in the following places?

a)    Classroom :        ______________________________________________________

b)    Playground:        ______________________________________________________

c)     Hallways/Corridor:        ________________________________________________

d)    Library:              ________________________________________________

e)    Toilet:                       ________________________________________________

f)      Canteen:    ______________________________________________________

a)    On the road while coming to/ going from school:

_________________________________________________________________.

  1. Do you have enough friends in your school? : _____________________________
  1. Do your friends help you when you are bullied? :        _____________________________
  1. Have you ever complained to your teacher? :           _____________________________
  1. Do other students say things which hurt your feelings?

a)    None

b)    Sometimes

c)     Often

  1. Do other students bully you by lying about you to others?

a)    None

b)    Sometimes

c)     Often

  1. Do other students bully you by physical touching as in a fight / push / kick / slap?

a)    None

b)    Sometimes

c)     Often

  1. Do other students bully you by leaving you alone in games, sports and other activities?

a)    None

b)    Sometimes

c)     Often

  1. Are there gangs in your class who bully others? If yes write their names.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________.

Category: Medical Questionnaire

Comments are closed.

Copy Protected by Chetans WP-Copyprotect.