Have you thrown a partner out of a house?

Have you prohibited a partner from getting a job, going to work, trading or earning money?

Have you spent money from your earnings for alcohol, tobacco, or other things for yourself when you knew your partner was finding it hard to afford the household expenses?

Do you own a weapon?

Have you ever been involved in a fight with a weapon?

Have you experienced any of the following forms of violence outside the home in the last 3 months: Other (specify)

Have you experienced any of the following forms of violence outside the home in the last 3 months: Threatened with a gun

Have you experienced any of the following forms of violence outside the home in the last 3 months: Threatened with a knife, broken bottle, or other weapon (excluding guns)

Have you experienced any of the following forms of violence outside the home in the last 3 months: Robbed

Have you experienced any of the following forms of violence outside the home in the last 3 months: Punched or Hit