Exit this survey Self Harm Student Survey Question Title * 1. If you share with us your email address, we will share with you resources regarding self harm. We promise not to share you information and if you wish to remain anonymous, this is not required. Name Email Address Question Title * 2. How old are you? under 10 10-12 13-15 16-18 Question Title * 3. How old were you when you first learned of the concept of self harm (cutting, etc)? under 10 10-12 13-15 16-18 I'm not sure what you are referring to? Question Title * 4. Where did you learn about self harm/cutting? Media (book, movie or TV) Internet Your Parent A friend Other (Please add in comments where you learned about self harm at the bottom of this survey) Question Title * 5. Have you ever cut on yourself or self harmed in some way? (If no, please skip to question 7?) Yes No Question Title * 6. If you have self harmed, how old were you the first time you cut on yourself? Under 10 Under 13 Under 16 Question Title * 7. Do you have a friend or know of someone in your school who self harms? Yes No Question Title * 8. What do you want to know more about when it comes to self harm? What causes someone to self harm How to quit self harming How to talk to your parents about self harm How to help a friend who self harms Question Title * 9. What advice would you give to someone thinking about hurting themselves? Question Title * 10. If you have a brief story about self harm that you think would help others and could be included in a book, please share this information without revealing any names. If you have self harmed and are willing to share what you believed caused this behavior and how you stopped, we'd love to hear what you have to say as well. (Please make this as few sentences as possible) Done