How many times have you forced an ex-girlfriend or ex-wife into having sex?

Has your current husband or partner hit you with an object in the last year?

Has a partner threatened to use or actually use a gun, knife or other weapon against you in the past year?

Has a male partner pushed you in the last year?

Has your current husband or partner hit you with a fist in the last year?

Has any male partner ever threatened to use or used a firearm, knife or other weapon against you?

Have you been pushed or shoved by a partner?

How often has your current husband or partner hit you with a fist?