Self Harm Survey

1

When are you first learned of the concept of self harm (cutting, etc)?

under 9

9-12

13-15

16-18

I'm not sure what you are referring to?

3

Have you ever cut on yourself or self harmed in some way?

Yes

No

5

Do you have a friend or know of someone in your school who self harms?

Yes

No

6

What do you want to know more about self harm?

What causes someone to self harm

How to quit self harming

How to talk to your parents about self harm

How to help a friend who self harms

7

Your Age

Younger than 12

12-17

18-25

26+

8

What advice would you give to someone self-harming or thinking about self-harming?

9

Do you want to share a brief story about self-harm that you think would help others?

10

Name

First Name

Last Name

11

Email

example@example.com