Cyber harassment report form can be filled out by any person who is a victim of cyber harassment. The person can be a man, woman, or child.
Cyber harassment is a serious problem that can have a lasting impact on its victims. If you have been a victim of cyber harassment, please take the time to fill out this form. Your information will help us better understand the problem and develop ways to address it.
What is your age?
What is your gender?
What is your race/ethnicity?
Have you ever been a victim of cyber harassment?
If yes, please describe the incident/s in detail.
How did the cyber harassment make you feel?
Have you ever been afraid for your safety as a result of cyber harassment?
Has the cyber harassment negatively affected your work or school performance?
Have you ever changed your behavior as a result of the cyber-harassment (e.g., stopped using certain social media platforms, or changed your phone number)?
Have you ever contacted law enforcement as a result of cyber harassment?
Would you like to provide any additional comments or information about your experience with cyber harassment?