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* Investigators: Doreen Creshine, BS; Megan Crofford, BS

Study Title: Experiences and Effects of Bullying on LGBTQ Adolescents and Young Adults

Purpose of the Study: This study will examine personal experiences with bullying and attempt to understand the effects of bullying on LGBTQ adolescents and young adults.

Risks and Discomforts: This survey includes questions about personal experiences with bullying and the effects of bullying. If these are particularly sensitive topics for you to discuss and you do not feel comfortable with this line of questioning, please remember you are free to close the survey at any point.

Confidentiality: All responses will be kept confidential.

Termination of Participation:At any point before or during the survey participants are able to withdraw from participation. Any questions answered will be cleared and not recorded.

Compensation:There is no compensation for participation in this study.

Questions:There will be XX questions in this survey and should take 5-10 minutes to complete.

Voluntary Participation: I understand that my participation in this study is entirely voluntary, and that refusal to participate will involve no penalty or loss of benefits to me. I am free to withdraw or refuse consent, or to discontinue my participation in this study at anytime without penalty or consequence. I voluntarily give my consent to participate in this research study.

Please give your consent by choosing ‘proceed to survey’.
 
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How old are you?
   
 
 
 
What is your gender?
 
Male
 
Female
 
Other
 
 
 
 
What is your sexual orientation?
 
Straight/Heterosexual
 
Gay/Lesbian/Homosexual
 
Bisexual
 
Other
 
 
 
 
Do you identify as a member of the LGBTQ community?
 
Yes
 
No
 
 
 
What is your religious preference?
 
Catholic
 
Christian
 
Jewish
 
Mormon
 
Muslim
 
Unitarian
 
Agnostic or Atheist
 
Other
 
 
 
 
When did you graduate from high school?
 
I did not graduate from high school