Welcome Parents to the Abuse Bites Parent Survey!

Please answer all questions and then hit submit. Thank you!

E-mail Address: *
What School Does Your child attend? *
What City & State do you live in? *
Sex? *
Race? *	White/Caucasion African American Latino Mixed Other
Sexual Orientation?	Heterosexual Homosexual / Gay Lesbian Bi-Sexual
How old/ and what grade is your child(ren) in? *
Has there been a problem with bullying at your childs school? *
In what ways has your child been bullied/abused? *	Verbal Physical Emotional Sexual Cyber Text Left Out/ Loner
In what ways has your child bullied/abused others? *	Verbal Physical Emotional Sexual Cyber Text
Has your child ever said they couldnt take it anymore or they wanted to die? If yes, what actions if any were taken... *
Has your child ever threatened another child? If so what actions if any were taken... *
What do you think is the biggest reason kids are bullying? *	No Policy/Rules at School Enforced Peer Pressure to Get Friends Theyre victims and afraid of being bullied Power & Control Bad Home Life
What have you as a parent tried to teach your child? *	Walk Away Fight Back Keep Quiet Buddy System Report it Help Others Dont Be A Loner
In the past what is the biggest way youve seen your child reacting to bullies? *	Walk Away Fight Back Report Bullying Keep Quiet Buddy System Standing Up For Themselves Standing Up for Others
Has there been a bullying problem in your community? If so, what have you done, and if anything, whats being done to stop it... *
What was your childs favorite part of our program? *	Dogs/ Trick Presentation Power Point/ Stories Games / Student Participation
What was your favorite part of our program?
Have you seen a difference in your childs behavior after we presented at their school? Please answer yes or no and Explain what is different. *
Does your school have an anti-bullying peer mentor group/program like our Bully Buster program? *
If no, do you hope they use our Bully Buster Program in the future?
Does your childs school have an anti-bullying policy in effect as well as an action plan? *	Yes No
Do you think your child would benefit from having our Bully Buster program in their school?
In what ways?
What are some things you didnt already know and helps you as a parent? *
How do you feel that our program is unique and stands out from all the other anti-bullying programs? *
Any thoughts on how we can make our program better? *
Overall how would you rate our program? *	1 (being the worst) 2 3 4 5 6 7 8 9 10 (being the best)
In what ways and how did you handle it? *
Have you ever been bullied or abused? *
Have you bullied or abused others? *
In what ways and how did they handle it? *
Have you or your child been bullied for moral, religious, or sexual beliefs? Please explain... *
If your child was bullying what would you as a parent do? *


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