Childhood Trauma Survey Questions Template is designed by experts. This questionnaire is designed to carry questions that helps a researcher identify, if a person has experienced any childhood trauma during the growing up years and what exactly is that trauma. There are 11+ questions in this sample survey template that will help collect detailed information regarding childhood trauma experienced by an individual. This form can be customized and more questions can be added to suit the research needs. You can use this questionnaire with young adults and grown-ups to find about their history regarding child abuse/trauma.
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What is your Gender? Which age bracket do you fall in? Please select your ethnicity. Please select your marital status. Do you have kids? Did your parents often abuse you? Did you lose a parent(s) during your childhood? During your childhood did your witness your mother or any other female member of the family being abused? Did any of your family member go to jail, when you were a kid? If Yes, then please select which family member of yours went to the jail. Is there any specific incident from your childhood that had a deep impact on you, that you would like to share? |