用3分钟回答本问卷，和我们一起反对种族歧视！Thank you for taking this survey and fight racial discrimination with us.

本问卷共有10个问题，大约需要花费您3分钟。/ This survey consisting of 10 questions and takes approximately 3 minutes to answer.

本问卷由墨尔本中文心理咨询Mindspace Consulting发起。您的匿名回答将被用于Mindspace的研究及科普文章，或共享数据给其他媒体（尤其ABC等澳洲主流媒体）以达到反对歧视、改善澳洲华人及亚洲社群的心理支持的目的。/ This survey is created by Mindspace Consulting, a psychological counselling service based in Melbourne. The data of your anonymous answer will be used to conduct independent research and educational content of Mindspace, and may also be shared to media (especial mainstream Australian media such as ABC) in hope to stop racial discrimination and provide more support for the Asian community.

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* 1. 您目前的居住地/Your current place of residency

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* 2. 请问您的种族或文化背景是？（可多选）/ What is your ethnic or cultural background? (multiple answers applicable)

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* 3. 您目前的国籍或签证状况/Residency status

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* 4. 您是否亲身经历了因疫情的种族歧视行为？/Have you directly experienced racial abuse due to COVID-19?

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* 5. 如果可以，请您描述您或家人朋友在疫情期间受到了什么样的种族歧视经历？ / If you feel comfortable, please share story of the racial abuse you or your friends/family have experienced during the COVID-19 pandemic?

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* 6. 您是否感受到了疫情带来更多种族歧视的压力？/ Do you feel under the COVID-19 pandemic, racism is bringing you more stress?

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* 7. 因疫情期间的被种族歧视经历/压力，您是否感受到以下负面情绪或感受？（可多选）/Due to COVID-19 related racial abuse or stress, have you experienced the following distress (multiple answers applicable)

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* 8. 您是否会考虑向Australian Human Rights Commission报告歧视行为？/ Would you consider report the discrimination or abuse to Australian Human Rights Commission?

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* 9. 您是否考虑过向寻求心理服务的帮助，来缓解种族歧视带来的压力和负面感受？/ Have you considered seeking psychological service to help with the stress/trauma caused by racial abuse?

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* 10. 您是否愿意接受进一步的匿名访谈，谈谈您经历的种族歧视和感受？/ Would you be willing to accept a further interview from us, to talk about the racial discrimination or abuse that you've experienced and how it's impacting your life?

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