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Pre-Case Harassment Questionnaire

It is vital that you provide honest answers to each of the questions below. If you’re not sure of something then just leave it out. No human is going to see your answers. It gets fed straight into our deep learning computer system that will look for patterns and other indicators that we can use to profile the harasser and focus in on a suspect.

Time and Frequency

How long ago did the harassment begin?

 This week
 This month
 Last month
 This year
 Last year
 Before last year

How often does it occur at the moment?

 Every day
 Every few days
 Every week
 Every fortnight
 Every month
 Occasionally (no set pattern)

How often did it occur at the beginning?

 Every day
 Every few days
 Every week
 Every fortnight
 Every month
 Occasionally (no set pattern)

Would you say that, over time, the harassment…

 Has become more frequent
 Has become less frequent
 Has stayed about the same
 Has started up again after a period of quiet
 Has gone quiet after a period of harassment
 Other (please describe below)

Which days of the week are most often (or only) harassed on?

 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
 Sunday
 I don’t know

Which days of the week are you never (or hardly) harassed on?

 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
 Sunday
 I don’t know

What times of the day are you most often (or only) harassed at?

 6am – 8am
 8am – 12pm
 12pm – 2pm
 2pm – 4pm
 4pm – 6pm
 6pm – 10pm
 10pm – 2am
 2am – 6am
 I don’t know

What times of the day are you never (or hardly) harassed at?

 6am – 8am
 8am – 12pm
 12pm – 2pm
 2pm – 4pm
 4pm – 6pm
 6pm – 10pm
 10pm – 2am
 2am – 6am
 I don’t know

method

What are the methods of harassment being used at the moment?

 Phone calls (Private number)
 Phone calls (Number displayed)
 SMS messages
 Emails
 WhatsApp
 Facebook
 Other (please describe below)

What were the methods of harassment at the beginning?

 Phone calls (Private number)
 Phone calls (Number displayed)
 SMS messages
 Emails
 WhatsApp
 Facebook
 Other (please describe below)

If applicable, which of the following email services were use by the harasser?

 Gmail.com or googlemail.com
 Yahoo.com, ymail.com, rocketmail.com
 Hotmail.com, msn.com, outlook.com
 Mail.com
 Webmail.co.za
 Multiple/Other (list all email address/es below, separated by commas):

If applicable, which of the following mobile phone numbers were used?

 060 or 061 number
 062, 072, 076, 079 or 082 number
 063, 073, 078 or 083 number
 064, 074 or 084 number
 071 or 081 number
 Multiple/Other (List all number/s below, separated by commas):

If applicable, which of the following social media platforms were used?

 Facebook
 Twitter
 Instagram
 Pinterest
 Youtube
 Reddit
 LinkedIn
 Google+
 Vine
 Tumblr
 Tinder
 Snapchat
 Ask.fm
 Multiple/Other (list all social networks below, separated by commas)

People

Who else has been (or claims to have been) harassed at around the same time as you?

 my current partner
 A close relative (parents, children, siblings)
 An extended relative (cousins, uncles, aunts)
 A friend of mine
 A friend of both mine and my current partner
 A friend of both mine and my ex partner
 A work colleague (co-worker, peer)
 my employer or manager
 An employee or subordinate
 my ex-partner
 my partner’s ex-partner
 Someone my partner knows
 Someone known to my ex-partner
 Someone else (please describe below)

Have any of the following people been mentioned by the harasser?

 my current partner
 A close relative (parents, children, siblings)
 An extended relative (cousins, uncles, aunts)
 A friend of mine
 A friend of both mine and my current partner
 A friend of both mine and my ex partner
 A work colleague (co-worker, peer)
 my employer or manager
 An employee or subordinate
 my ex-partner
 my partner’s ex-partner
 Someone my partner knows
 Someone known to my ex-partner
 Someone else (please describe below)

Have any of the following people offered to help you investigate the harassment?

 my current partner
 A close relative (parents, children, siblings)
 An extended relative (cousins, uncles, aunts)
 A friend of mine
 A friend of both mine and my current partner
 A friend of both mine and my ex partner
 A work colleague (co-worker, peer)
 my employer or manager
 An employee or subordinate
 my ex-partner
 my partner’s ex-partner
 Someone my partner knows
 Someone known to my ex-partner
 Someone else (please describe below)

Were any of the following people harassed before your harassment began?

 my current partner
 A close relative (parents, children, siblings)
 An extended relative (cousins, uncles, aunts)
 A friend of mine
 A friend of both mine and my current partner
 A friend of both mine and my ex partner
 A work colleague (co-worker, peer)
 my employer or manager
 An employee or subordinate
 my ex-partner
 my partner’s ex-partner
 Someone my partner knows
 Someone known to my ex-partner
 Someone else (please describe below)

Suspects

Do you suspect someone in particular is behind the harassment?

 Yes
 No

Why do you suspect that person?

 They have done this to others before
 They have done this to me before
 They have threatened to do this before
 The timing of the harassment coincides with an incident involving that person
 Other (please describe below)

How is your suspect connected to you?

 My current partner
 A close relative (parents, children, siblings)
 An extended relative (cousins, uncles, aunts)
 A friend of mine
 A friend of both mine and my current partner
 A friend of both mine and my ex partner
 A work colleague (co-worker, peer)
 my employer or manager
 An employee or subordinate
 my ex-partner
 my partner’s ex-partner
 Someone my partner knows
 Someone known to my ex-partner
 Someone else (please describe below)

Assistance

Have you reported the matter to the police (whether or not they did anything about it)?

 Yes
 No

Did the police take your statement?

 Yes
 No

Was a criminal case opened?

 Yes
 No
 If yes, please provide the Station and CAS number below

Has an investigating officer contacted you?

 Yes
 No
 If yes, please provide their Rank, Name and Phone number below

Have you contacted any Service Provider for assistance?

 Yes
 No
 If yes, please provide details below

Did you receive any assistance from the Service Provider?

 Yes
 No
 If Yes, please describe below what was done
 If No, please describe below what reasons were given

Have you been to see or instructed an attorney to assist you?

 Yes
 No
 If yes, what is the attorney’s Name and Phone Number?

Have you used the services of a private investigator to investigate this matter (at any time)?

 Yes
 No
 If yes, please provide their Name and Phone Number below
 If yes, please explain below what was done

Have you requested assistance from anyone else in the real world (as opposed to online)?

 Yes
 No
 If yes, please provide details below

Have you posted a question or requested assistance online?

 Yes
 No
 If yes, please list the website URLs below, separated by commas

Nature

Which best describes the nature of the content of the harassment (if applicable)?

 Threatening (explicit, e.g. “I will kill you”)
 Intimidating (implicit, e.g. “I know where you live”)
 Derogatory (insults directed at me)
 Sexual (including images)
 Sexual (without images)
 Extortion or Blackmail
 Defamatory (statements made to others to harm my reputation or integrity)
 Nuisance (repetative, disruptive, irritating)
 Other (please explain below)

Are you being blamed or accused of something? If yes, choose all that apply.

 I’m accused of having done something (that I did do)
 I’m accused of having done something (that I didn’t do)
 I’m accused of not doing something (that I did do)
 I’m accused of not doing something (that I never did)
 I’m blamed for causing something (that I did cause)
 I’m blamed for causing something (that I didn’t cause)
 I’m blamed for prevented something from happening (that I did prevent)
 I’m blamed for prevented something from happening (that I didn’t prevent)
 Something else (please explain below)

Do any of the following events coincide with the start or a recurrence of the harassment?

 I broke up with my ex-partner
 My partner broke up with their ex-partner
 I began a relationship with someone
 I had an affair
 I caught my partner cheating
 I caught my ex-partner cheating
 I got engaged or married
 I got pregnant or had a child
 I got divorced or received custody of a child
 I got promoted at work
 Someone got fired, demoted or disciplined at work
 I had an argument or altercation with someone
 I opened a criminal case against someone
 I got a summons commencing legal action
 I started a new job
 I got transferred to another town
 I won a prize, competition or award
 I evicted a tenant or room mate
 I moved house
 I was involved in an accident
 I appeared on TV, radio, or in print media
 I launched a new business or product
 Other (please provide details below)