Has a male partner ever kicked, dragged, beaten, choked or burned you?

Has a male partner ever hit you with a fist or with something else that could hurt you?

Have you threatened to use or actually used a gun, knife or other weapon against your partner in the last twelve months?

Have you ever threatened to use or actually used a gun, knife or other weapon against a partner in the last year?

Have you slapped your partner or thrown something at her that could hurt her in the last twelve months?

Have you ever slapped a partner or thrown something at her that could hurt her in the last year?

Have you ever pushed or shoved a partner in the last year?

Have you pushed, cornered, or pulled your partner’s hair in the last twelve months?

Have you kicked, dragged, beaten your partner in the last twelve months?

Have you ever kicked, dragged, beaten, choked or burned a partner in the last year?