Online Registration Form

Thank you for your interest in joining the in-depth interview for the research on cyber dating/relationship abuse among young people. Please provide us with your information and we will contact you shortly.

Data collected will be used for research purposes only. Anonymity of participants, as well as the confidentiality of data, will be strictly guaranteed. Should you have any question regarding the study, please contact Dr YIP, Postdoctoral Fellow of Gender Research Centre of the Hong Kong Institute of Asia-Pacific Studies by email (grcentre@cuhk.edu.hk) or by phone (3943 8775).

Nick Name (How would you like to be addressed?)
Cyber dating abuse experience

Cyber dating abuse experience Non-consensual sharing of personal or intimate information Non-consensual sharing of intimate images or videos Non-consensual publishing of photos of a sexual nature Spreading of rumours Making threats Encountering attempts to scare Insulting Blackmailing
Whether cyber dating abuse experience occurs in current or previous relationship?

Whether cyber dating abuse experience occurs in current or previous relationship? Current relationship Previous relationship
Are you still suffering from the consequences of cyber dating abuse experience?

Are you still suffering from the consequences of cyber dating abuse experience? Yes No
Age (years old)
Sex-assigned at birth

Sex-assigned at birth Male Female Intersex
Gender identity

Gender identity Woman Man Bigender Cisgender Transgender Non-binary Genderqueer Gender Fluid Gender Neutral Other Other
Sexual orientation

Sexual orientation Heterosexual Homosexual Bisexual Asexual Pansexual Queer Other Other
Ethnicity
Email address or other contact channels
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