I'm Gonna Write That Down Question Title * 1. Have you been bullied? Yes No Question Title * 2. Please indicate any of the forms of bullying that have happened to you. Physical (threats of violence) Verbal Text message Email Social media (Facebook, Twitter, Instagram, Topix, etc.) Spreading rumors Excluding Question Title * 3. Have you ever bullied someone? Yes No Question Title * 4. Have you witnessed bullying at our school? Yes No Question Title * 5. Have you ever intervened or tried to help when you have seen bullying happen? Yes No Question Title * 6. Have you told an adult about bullying that happened to you or someone else? Yes No Question Title * 7. If you have seen bullying, where did you see it happen? Please be as specific as possible. (For example, if it was the bathroom, which bathroom? If it was on the bus, what bus?) Question Title * 8. Who do you think the bullies are in the school? (Please list name(s) below.) Done