Peer Pressure Survey Form
Please complete the Peer Pressure Survey Form to help us understand your experiences and behaviors related to peer pressure. All responses are anonymous.
How often do you feel pressured by your peers to do something you are uncomfortable with?
*
Never
1
2
3
4
Very Often
5
1 is Never, 5 is Very Often
Which of the following areas do you most frequently experience peer pressure?
*
Social activities
Substance use
Academic performance
Appearance or fashion
Other
How likely are you to go along with your friends even if you disagree with them?
*
Very Unlikely
1
2
3
4
Very Likely
5
1 is Very Unlikely, 5 is Very Likely
Please rate your confidence in saying 'no' to peer requests you are uncomfortable with.
*
1
2
3
4
5
How often do you encourage others to resist negative peer pressure?
*
Never
1
2
3
4
Always
5
1 is Never, 5 is Always
Have you ever regretted a decision made due to peer pressure?
*
Yes
No
Not sure
How comfortable do you feel discussing peer pressure with a trusted adult?
*
Not Comfortable
1
2
3
4
Very Comfortable
5
1 is Not Comfortable, 5 is Very Comfortable
In which settings do you experience the most peer pressure?
*
School
Online/social media
Sports teams/clubs
Family gatherings
Other
Please indicate the extent to which you agree with the following statements about peer pressure.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Peer pressure is a normal part of growing up.
1
2
3
4
5
It is important to fit in with my peers.
6
7
8
9
10
I can identify when I am being pressured.
11
12
13
14
15
I know strategies to resist peer pressure.
16
17
18
19
20
If you would like, please briefly describe a situation where you experienced peer pressure.
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