*1.What is your gender?(Required.)

Female

Male

Other

Prefer Not to Say

*2.What is your age?(Required.)

under 18

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

*3.In what country do you live?(Required.)

AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCôte D'IvoireCroatiaCubaCyprusCzech RepublicDemocratic People's Republic of KoreaDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea BissauGuyanaHaitiHoly SeeHondurasHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesia (Federated States of)MonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRepublic of KoreaRepublic of MoldovaRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth ‎SudanSpainSri LankaState of PalestineSudanSurinameSwazilandSwedenSwitzerlandSyrian Arab RepublicTajikistanThailandThe former Yugoslav Republic of MacedoniaTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited Republic of TanzaniaUnited States of AmericaUruguayUzbekistanVanuatuVenezuela (Bolivarian Republic of)VietnamYemenZambiaZimbabwe

*4.How many times a day would you go online? ( Reading the news, social media, blogs, online forums, chat rooms, work)(Required.)

0

1 to 5 

6 to 10

11 to 20

20 to 50

50+

*5.How many times a day would you post something online?(Required.)

0

Seldom or rarely

1

2 to 4

5 to 10

10+

*6.How many times have you seen a negative comment online?(Required.)

0

1 to 5 

6 to 10

10 +

*7.Have you ever had a negative comment written to you online?(Required.)

Yes

No 

Prefer Not to Say

*8.Have you ever been harassed, abused, stalked or bullied online?(Required.)

Yes

No 

Prefer Not To Say

*9.Has anyone ever made a comment or posted photos or videos online that has impacted your mental health?(Required.)

Yes

No

Prefer Not To Say

*10.How has your experience of Social Media impacted your mental health?(Required.)

Feel More Content

Low Self Esteem

Happy

Depressed or Anxious

Light hearted

Stressed  

Positive impact on my life, work and family

Negative impact on my life, work and family

Prefer Not to Say

*11.If you were harassed, abused, stalked or bullied online what would you do?(Required.)

Ignore it

Write Back

Report it to an appropriate website

Report it to a law enforcement agency

Tell friends or family

Prefer not to say

*12.If you have reported any kind of online abuse/bullying/harassment what has been the response time?(Required.)

Never reported anything

24 – 48 hrs

Up to 72 hrs

1 week

2 – 4 weeks

Greater than 4 weeks

I didn’t hear back

Prefer Not to Say

*13.From your report what was the result?(Required.)

Never reported

Abuser banned from social media

Site shut down

Account deleted from social media

Nothing

Prefer Not to Say

*14.Who would you like to take action regarding the state of the internet?(Required.)

Social Media Companies

Police

Government

Everyone

No one

Prefer Not to Say

*15.Do you know anyone who has been harassed, abused, stalked or bullied online?(Required.)

Yes

No 

Prefer Not To Say

*16.If witnessing online harassment or abuse happening to another what would you do?(Required.)

Report it

Nothing

Step in

Prefer Not to Say

*17.Is freedom of speech(Required.)

The right to abuse

The ability to speak with no accountability

The responsibility of respecting peoples choices 

The right to speak your opinion regardless 

The right to be free from harm or hate

Prefer Not To Say

*18.Have you ever experienced yourself making comments online you would not consider voicing in person? Positive or Negative(Required.)

Yes

No 

Prefer Not To Say