Depression and Internet

Questions marked with an * are required

* Age:

Do you suffer from depression?

Yes

No

Have you ever been the victim of physical, verbal, or psychological bullying? (in person)

Yes

No

Have you ever been the victim of cyber bullying?

Yes

No

If yes, was the bully anonymous?

Yes

No

Both

Have you ever participated in self-harm?

Yes

No

Have you ever contemplated suicide?

Yes

No

Have you ever attempted suicide?

Yes

No

If you answered yes to any of the previous questions, do your parent(s)/guardian know that you are/were struggling with this?

How much time on average do you spend on the internet daily?