Intimate Partner Violence
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Emotional Violence |
Has your (current/most recent partner) ever become angry when you speak to other men?
Does your (current/most recent) partner insist on knowing where you were at all times?
Does your (current/most recent) partner ever forbid you from seeing your friends?
Has your partner ever done something to frighten or intimidate you? (eg, in the way she/he looks at you or by yelling or breaking something?)
Has your partner ever threatened to hurt you or someone you care about?
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Physical Violence (moderate)* |
Has your partner ever slapped you or thrown something that could hurt you?
Has your partner ever pushed or shoved you?
Has your partner ever hit you with his hand or with something else that could hurt you?
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Physical Violence (severe)† |
Has your partner ever kicked, dragged or beaten you?
Has your partner choked you or burned you intentionally?
Has your partner THREATENED to use a gun, knife or other weapon against you?
Has your partner ACTUALLY used a gun, knife or other weapon against you?
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Sexual Violence |
Has your partner ever forced you to have sex by using threats or intimidation (not physical violence)?
Has your partner ever physically forced you to have sex when you did not want to?
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Non-partner violence
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Physical Violence |
Has anyone who is not your intimate partner ever beaten you with a fist, or kicked you, or hurt you with a stick or other object?
Has anyone who is not your intimate partner ever used a gun, knife or other weapon against you?
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Sexual Violence |
Has anyone who is not your intimate partner ever forced you to have sex when you did not want to, for example by threatening you, holding you down, or putting you in a situation where you could not say no?
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