Online Childhood Trauma Questionnaire


An online childhood trauma questionnaire is a questionnaire which is meant to understand the situation and position of a person’s childhood trauma condition. Such questionnaires are really important to understand the trends of the reasons for trauma in the childhood of different people.

Sample online childhood trauma questionnaire:

Name: ______________

Age: ________________

Address: ____________________

Email address: ______________

Contact number: ____________________

Q1. What kind of a childhood did you have in general?

______________________________

Q2. Do you have more of happy childhood memories or sad ones?

____________________________

Q3. Were both your parents alive during your childhood?

__________________________

Q4. Did you live with your parents during your childhood years?

__________________________

Q5. Which is your fondest childhood memory?

_________________________

Q6. Which is the saddest or traumatised childhood memory that you have?

______________________________

Q7. Were you a happy kid during childhood years?

_______________________________

Q8. Were you beaten in your childhood?

_____________________________

Q9 Were you bullied by your friends or anyone else during your childhood years?

________________________________

Q10. Mention the names of people who you were not very fond of during your childhood?

_________________________________________

Q11. Is there any major trauma related with your childhood that you would like to share with us?

______________________________________

Q12. Were you sexually assaulted on any occasion during your early years?

_________________________________________

Q13. Were you physically harmed during your early years?

____________________________________________

Q14. How did you cope with the trauma (if any) during your childhood years?

___________________________________

Q15. Did the trauma made you dull and inactive in any manner?

_________________________

Q16. Give details of your trauma (if any)

____________________________________________________

Category: Online Questionnaire

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